Palliative radiotherapy for patients with inoperable esophageal cancer

The effectiveness of palliative radiotherapy was evaluated in 59 patients with inoperable esophageal cancer. The cancers were most often inoperable because of invasion to the trachea and bronchus: hematogenous metastasis had occurred in several cases. The scheduled dose of more than 50 Gy was successfully administered to 84.7% of patients ; reasons for lesser doses included hematemesis, fever, and bypass surgery. The immediate cause of death in 24 cases was pneumonia or pyothorax due to recurrent nerve paralysis or esophagobronchial fistula. Distant metastasis occurred in only eight cases. The survival rate of 50 patients that received the scheduled dose was 66% at 6 months, 20% at 1 year, and 6% at 2 years. There were no significant differences in survival rates between patients with locally deep invasion and patients with distant metastasis. Since there were few significant adverse reactions, we thought to be able to treat patients with advanced esophageal cancer by the nearly radical radiotherapy. (author)