RESULTS of Concurrent Chemoradiotherapy and Intraluminal Brachytherapy in Esophageal Carcinoma: Retrospective Analysis with Respect to Survival

Nam, Taek Keun; Nah, Byung Sik; Chung, Woong Ki; Ahn, Sung Ja; Song, Ju Young

Abstract

PURPOSE: To evaluate the efficacies and toxicities of concurrent chemoradiotherapy (CCRT), with or without intraluminal brachytherapy (ILB), using a retrospective analysis in esophageal carcinomas with respect to survival.
MATERIALS AND METHODS
From April 1995 to July 2001, a total of 65 patients, diagnosed with an esophageal carcinoma, were treated by CCRT, with 21 also treated by ILB after CCRT. External radiotherapy was performed using 6 or 10 MV X-rays, with a dose range of 46.8~69.6 Gy (median; 59.4). The ILB was performed using high-dose-rate brachytherapy with Ir-192. The fractionation of ILB was 3 Gy by 4, or 5 Gy by 2 fractions. Cisplatin (75 mg/m2) was given on each first day of weeks 1, 5, 9 and 13, and 5-FU (1,000 mg/m2) as a continuous infusion for the first 4 days of each course.
RESULTS
The median survival time of all patients was 15 months, and the 1, 2 and 3-year survival rates were 55.4, 29.2 and 20.7%, respectively. The 2-year survival rates of the patients with and without ILB were 33.3 and 27.3%, respectively (p=0.80). The 2-year survival rates of the patients with a complete, partial and no response were 44.1, 13.8 and 0%, respectively (p=0.02). The response to treatment was the only significant factor affecting the overall survival from a multivariate analysis.
CONCLUSIONS
This study has shown that the survival outcomes of CCRT were much better than previous results with radiotherapy alone. However, the addition of ILB after CCRT showed no advantage over that of CCRT alone.