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J Korean Soc Ther Radiol Oncol > Volume 22(1); 2004 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2004;22(1): 25-32.
RESULTS of Concurrent Chemoradiotherapy and Intraluminal Brachytherapy in Esophageal Carcinoma: Retrospective Analysis with Respect to Survival
Taek Keun Nam, Byung Sik Nah, Woong Ki Chung, Sung Ja Ahn, Ju Young Song
Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea. tknam@chonnam.ac.kr
To evaluate the efficacies and toxicities of concurrent chemoradiotherapy (CCRT), with or without intraluminal brachytherapy (ILB), using a retrospective analysis in esophageal carcinomas with respect to survival.
From April 1995 to July 2001, a total of 65 patients, diagnosed with an esophageal carcinoma, were treated by CCRT, with 21 also treated by ILB after CCRT. External radiotherapy was performed using 6 or 10 MV X-rays, with a dose range of 46.8~69.6 Gy (median; 59.4). The ILB was performed using high-dose-rate brachytherapy with Ir-192. The fractionation of ILB was 3 Gy by 4, or 5 Gy by 2 fractions. Cisplatin (75 mg/m2) was given on each first day of weeks 1, 5, 9 and 13, and 5-FU (1,000 mg/m2) as a continuous infusion for the first 4 days of each course.
The median survival time of all patients was 15 months, and the 1, 2 and 3-year survival rates were 55.4, 29.2 and 20.7%, respectively. The 2-year survival rates of the patients with and without ILB were 33.3 and 27.3%, respectively (p=0.80). The 2-year survival rates of the patients with a complete, partial and no response were 44.1, 13.8 and 0%, respectively (p=0.02). The response to treatment was the only significant factor affecting the overall survival from a multivariate analysis.
This study has shown that the survival outcomes of CCRT were much better than previous results with radiotherapy alone. However, the addition of ILB after CCRT showed no advantage over that of CCRT alone.
Key Words: Esophageal neoplasms, Radiotherapy, Chemotherapy, Brachytherapy
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