Radiotherapy of esophageal carcinoma: role of high-dose-rate intracavitary irradiation.

A total of 119 patients with squamous cell carcinoma of the esophagus who were seen during a 10-year period were analyzed retrospectively in terms of survival rate and local control rate in relation to treatment method and disease stage. All patients were treated with radiotherapy alone: 43 patients were treated with external irradiation plus high-dose-rate intracavitary irradiation (Group 1), 46 with external irradiation only, to 50 Gy or more (Group 2), and 30 with external irradiation to less than 50 Gy (Group 3). All patients of Group 3 died within 8 months (mean 3.5 months) after the initiation of radiotherapy. In Group 1, the 2-year survival rate was 27.9% for the patients in all disease stages and 44.0% for those in Stage 1 and Stage 2 in contrast to Group 2, with a 2-year survival rate of 4.3% for the patients in all stages and 9.1% for those in Stage 1 and 2. The local control rate was 62.8% in Group 1, significantly higher than 19.6% in Group 2. It is concluded that high-dose-rate intracavitary irradiation following external irradiation is an effective treatment modality for esophageal carcinoma, especially in a limited stage.