Staging and prognosis using endosonography in patients with inoperable esophageal carcinoma treated with combined intraluminal and external irradiation.
Brachytherapy and external irradiation combined are an alternative to surgery in the treatment of advanced esophageal cancer. Endosonography has proved to be an accurate method of staging the depth of tumor invasion of esophageal cancer. Sixty-three patients with inoperable esophageal cancer underwent endosonography followed by combined brachytherapy and external irradiation. Staging was incomplete in 31 of 63 patients because of tight stenosis or difficulty in imaging celiac lymph nodes. During follow-up of 23 patients, reduction of tumor thickness and lymph node abnormalities was observed in 16. The median survival was 10.4 months. Survival time was correlated with initial number of metastatic lymph nodes found by endosonography. Paradoxically, the survival of patients with more extensive intra-luminal tumor growth was significantly better than survival of those with less tumor growth. In summary, the response to combined brachytherapy and external irradiation could accurately be assessed with endosonography. Lymph node abnormalities and tumor thickness were closely related to survival rate.
Tio
L T
LT
Georgetown University Medical Center, Division of Gastroenterology, Washington, DC 20007-2197.
Blank
L E
LE
Wijers
O B
OB
den Hartog Jager
F C
FC
Van Dijk
J D
JD
Tytgat
G N
GN
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary; D002588:Cesium Radioisotopes / Q000627:therapeutic use; D020698:Duodenoscopes; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D020701:Esophagoscopes; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D012074:Remission Induction; D015996:Survival Rate; D018084:Ultrasonography, Interventional
D002588:Cesium Radioisotopes