Intraoperative radiotherapy for 30 esophageal carcinoma patients
Yan, F-lai.; Zhou, X-ming.; Chen, Q-xun.; Jiang, R-xuan.; Fang, J.; Lian, Y-hong.; Zheng, X.; Chen, X-yong.; Zhu, Y.; Di, X-yun.; Wang, J.
Zhonghua Zhong Liu Za Zhi 25(2): 178-180
2003
ISSN/ISBN: 0253-3766 PMID: 12795849 Document Number: 559518
Objective: To analyze the complications and treatment results of intraoperative radiotherapy (IORT) for esophageal carcinoma. Methods: Sixty patients with thoracic esophageal carcinoma underwent esophagectomy through right thoractomy, 30 patients of whom received IORT of 15-25 Gy. Results: In patients who underwent IORT, 2 cases of pneumonitis, 1 case of anastomotic leak and 1 case of incisional wound infection were found. In patients underwent surgery only, 1 case of thoracic empyema and 1 case of anastomotic leak were found. All the complications ultimately healed. There was no operative mortality. During the follow-up of 3 years, in patients who underwent IORT, 2 of 3 died of radiation pneumonitis 24 and 26 months after IORT with one complicated with bronchoesophageal fistula. One of 3 died of multiple lung metastases. The 3-year survival rate was 88.0% (22/25) in IORT group and 76.0% (19/25) in surgery only group. Conclusion: Intraoperative radiotherapy can reduce locoregional recurrence if performed to thoracic esophageal carcinoma patients without surgical contraindication or distant metastasis. Radiation pneumonitis, a common complication difficult to manage, implies a poor prognosis and, consequently, the lung and bronchus should be protected from the radiation.