CARCINOMA OF ESOPHAGUS - SITES OF RECURRENCE AND PALLIATIVE BENEFITS AFTER DEFINITIVE RADIOTHERAPY

Seventy-two patients were studied who had carcinoma of the esophagus treated by radiation therapy. An analysis of sites of failure in both early and late stage patients revealed that control of local disease in Stage I was good; only 25% of patients developed local failure. Two other important sites of failure occurred, i.e. marginal recurrence in the esophagus outside the treatment field (25%) and distant metastases (25%). All local recurrences occurred at doses less than 105 time dose-factor (TDF). In patients with Stage II and III disease 64% of evaluable patients had local recurrences. Palliation of symptoms was achieved in a high proportion of patients. Sixty-three per cent of patients had complete disappearance of symptoms, while a further 21% had partial resolution. Complete resolution of symptoms was achieved in over 75% of patients with lesions <5 cm, but only 29% with lesions <9 cm. The probability of complete resolution is significantly greater when doses of greater than 100 TDF are given. Serious complications occurred in only 3 of the 72 patients. Implications for further directions in management are discussed. © 1978.