Afterloading interstitial brachytherapy combined with external radiation and surgery in the treatment of locally far-advanced lung cancer and esophageal cancer
Takagi, I.
Nihon Kyobu Geka Gakkai 36(10): 2200-2212
1988
ISSN/ISBN: 0369-4739 PMID: 3209875 Document Number: 310583
From 1981 to 1986, interstitial brachytherapy of 192Ir seed-assemblies using afterloading techniques was administered to four patients with Pancoast tumor, two patients with esophageal cancer infiltrating the aorta, and two patients with esophageal cancer infiltrating the left main bronchus, which was not completely surgically resected in either case due to invasion of adjacent organs. Three of the four patients with Pancoast tumor died between eight and 36 months following surgery, and one patient has survived 30 months postoperatively. Despite incomplete resection, symptoms were diminished in the four patients with Pancoast tumor; three of the four patients survived more than one year. The two patients with esophageal cancer and aortic invasion died within seven months after surgery. One of the two patients with esophageal cancer and bronchial invasion died in two months, while the other patient is alive four months after surgery. Autopsies performed on the two patients with esophageal cancer with aortic invasion and on one patient with esophageal cancer with bronchial invasion histologically revealed no residual tumor of the aortic wall or left main bronchus. Significant differences in life-prolongation were not observed, but significant differences in the prevention of localized recurrence were noted in the four cases of Pancoast lung cancer, suggesting possible effectiveness in cases of esophageal cancer with aortic infiltration and esophageal cancer with infiltration of the bronchus. It is concluded that interstitial brachytherapy combined with external radiation is more effective than external radiation alone in controlling the residual tumors of the brachial plexus, aortic wall, bronchus and perhaps other deep-seated thoracic organs that are difficult to remove.