Klin Onkol 1997; 10(5): 145-147.
Since November 1994 till July 1995 we performed intraluminal brachytherapy in 13 paatients with oesophageal malignant stenosis at the Institute for Radiation Oncology in Prague. All patients were contraindicated for surgery because of advanced tumor, medical problems or age. The histology was epidermoid carcinoma in 10 cases, adenocarcinoma in 2 cases and mucoepidermoid carcinoma in 1 case. The malignant obstruction was localised in various parts of thoracic oesophagus. All patients had I-IV degree of dysphagia according to O´Rourke classification. External irradiation was performed in all patients with doses 40-60Gy. Brachytherapy was performed using LDR/MDR Selectron. We used a single fraction of 10 Gy or two fractions of 7,5-13,5 Gy given 1 cm of the source axis depending on the external beam dose. The dose rate was on average 10,8Gy/h in the reference point. Evaluation of patients was performed in November 1995 with a minimal follow up of 4 months. 13,12,10 and 8 patients were alive after 1,2,3 and 4 months. Dysphagia improved in all patients by at least 1 degree. We did not meet any mechanical complications during introduction of the applicator. One patient surviving 12 months developed a benign oesophageal stenosis, which was treated by a stent. Intraluminal brachytherapy is an effective method of palliation of dysphagia caused by malignant obstruction of oesophagus with minimal complications. High dose rate machines are prefered because of short application time and higher comfort for the patients. Our experience in accordance with the literature shows, that low/medium dose treatment can be well-tolerated and successful.
