1996 Volume 8 Issue 1 Pages 51-56
Twenty-four patients who received radical radiotherapy for superficial esophageal cancers between October, 1982 and September, 1994 (“ep” in 1, “mm” in 4, “sm” in 19) were evaluated. The median age of the patients was 71 years (57-84), the median follow-up period was 48 months (4 months to 12 years and 3 months), and the male-female ratio was 23: 1.
Radiotherapy was performed by external irradiation alone in 15 patients and external irradiation plus intraluminal irradiation in 9 patients. The cummulative survival rate were calculated by the Kaplan-Meier method.
(1) Local recurrence was observed in 7 patients, of whom 4 had recurrence inside the irradiation field and 3 had recurrence outside the irradiation field.
(2) Local recurrence was observed in all “sm” patients, but not at all in the “ep” and “mm” paients.
(3) The 2-year and 5-year local control survival rates were 75.0% and 62.5%, respectively.
(4) Death was observed in 13 patients, of whom 3 died of esophageal cancer, 4 died of other cancers, and 6 died of other diseases.
(5) The 2-year and 5-year survival rates and primary disease survival rates were 76.7% and 36.5%, respectively, and 90.9% and 79.8%, respectively.
(6) As delayed complications, esophageal constriction, ulcer, and bronchial ulcer were noted in 1 each (total 3 cases, 12.5%), but the ulcer proved manageable by subsequent treatment.
Although superficial cancers evaluated in this study had disadvantages for radical radiotherapy, such as the high incidence of multiple cancers and complications, a satisfactory primary disease survival rate was obtained. Concerning local control, however, recurrence was often observed in the “sm” group, and improvements in local control and the establishment of treatments according to the depth of invasion and the presence or absence of lymph node metastasis are considered to be needed.
