Intraluminal irradiation for T2M0 esophageal cancer: effect of patient selection on prognosis.
The contribution of intraluminal irradiation to the prognosis of T2M0 esophageal cancer was examined with reference to patient selection. To determine the effect of patient selection, we used esophagrams to assess the potential difficulty of inserting a tube for intraluminal irradiation in 39 patients who were treated with external irradiation prior to 1982. Twenty-two patients were assessed as likely to have been able to undergo intraluminal irradiation (group 1) while 17 were assessed as unlikely to have been able to undergo the procedure (group 2). Of 36 patients treated after 1983, 19 patients were treated with a combination of intraluminal irradiation and external beam therapy (group 3) and 17 by external irradiation alone (group 4). The median survival times of groups 1, 2, 3, and 4 were 10.8, 6.4, 12.0, and 8.5 months, respectively. The prognosis of patients treated with combination therapy (group 3) was superior to that of those treated before 1982 (groups 1 + 2). However, there was no improvement in the prognosis of T2M0 esophageal cancer treated by radiotherapy after the introduction of intraluminal irradiation, and the difference between the survival curves of patients treated by combination therapy (group 3) and with a wide esophageal lumen (group 1) was not significant. Our study thus showed that the selection of patients according to the insertability of the intraluminal therapy tube affected the prognosis.
Nakajima
T
T
Department of Radiology, Osaka City University Medical School, Japan.
Fukuda
H
H
Hosono
M
M
Tsumura
M
M
Tada
T
T
Nishita
T
T
Tashiro
M
M
Hirokawa
K
K
Onoyama
Y
Y
D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy*; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D004938:Esophageal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D004947:Esophagus; D005260:Female; D006801:Humans; D007440:Intubation; D008297:Male; D011379:Prognosis; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
D003037:Cobalt Radioisotopes