Prospective study of external radiotherapy with and without intraluminal brachytherapy for esophageal cancer in Japan. JASTRO Study Group.

To improve the results of treatment of patients with esophageal cancer, it is important to achieve good local control. Since the esophagus is adjacent to highly radiation-sensitive organs such as the lungs, bone marrow, etc., it is difficult to irradiate tumors with high doses. Although irradiation techniques have improved as a result of advances in treatment-planning equipment and irradiation equipment, there are still some patients for whom radical radiation therapy within doses that the bone marrow and lungs can tolerate is difficult with external irradiation alone. On the other hand, intraluminal brachytherapy allows high-dose irradiation of esophageal cancer with little risk to adjacent organs. However, intraluminal brachytherapy, in which the dose sharply declines with the distance from the radiation source, is suggested to be a useful technique for tumors with relatively shallow invasion. With the aim of improving the results of esophageal cancer treatment, we designed this study to establish the optimal irradiation method in radical radiation therapy for esophageal cancer by clinically evaluating external irradiation alone and in combination with intraluminal brachytherapy.