High-dose-rate intraluminal brachytherapy (HDRIBT) for esophageal cancer.

High-dose-rate intraluminal brachytherapy (HDRIBT) for patients with esophageal cancer has been performed with and without external radiotherapy (ERT) in our department since May 1980. From May 1980 through December 1986, 92 patients with esophageal squamous cell carcinoma were treated with HDRIBT following ERT. These patients were divided into a limited disease (LD) group and an extensive disease (ED) group. Complete response and partial response rates after treatment were 48% and 38% in the LD group, and 9% and 65% in the ED group, respectively. The median survival time and 2-year survival rate was 13 months and 39% in the LD group, and 8.5 months and 7% in the ED group, respectively. The 5-year survival was 17% in the LD group. HDRIBT without ERT was used to treat six patients with small, superficial esophageal squamous cell carcinoma from August 1987 through July 1988. No patients were candidates for surgery because of coexisting medical problems. Each patient received 6 Gy per treatment, twice weekly with a total of 24 Gy; five of the six patients were treated on an outpatient basis. The tumor had disappeared completely in all six patients at the time of first follow-up endoscopic study less than 1 month after treatment, and no local recurrence had occurred after 11 to 22 months in five of the six patients. Five of the six patients were alive after 11 to 22 months, and one died with mediastinal metastasis at 15 months.