Abstract

Our study looked at patients with esophageal adenocarcinoma treated with high dose rate brachytherapy (HDR-BT) followed by external beam radiation treatment (EBRT) and chemotherapy with and without surgery to find local response using special HDR-BT delivery catheter, Bonvoisin-Gerard Esophageal Applicator (BG Applicator). We reviewed eight patients’ charts with adenocarcinoma of esophagus (Median age = 63.5 years, median follow up = 32 months). They received HDR-BT using BG Applicator that provides advantages such as: (1) Proper radiation source positioning; (2) Decrease hot mucosal spots; (3) Bougienage of the obstruction by use of bougie tube, and (4) Decrease rate of local side effects. Descriptive analysis was performed and biopsy/surgical pathology results were reported to determine the local histopathological response. Two patients did not receive surgery and had a complete local response; one of which developed cancer at a lymph node site with no cancer at primary site on follow-up. Five patients completed treatment, of which four showed complete local response and only one of those four developed distant bony metastasis with negative primary site. One patient died due to stroke. HDR-BT with BG applicator gives promising locoregional response in esophageal cancer that needs to be confirmed by further systematic randomized trials.

Key words: High dose rate brachytherapy, external beam radiation therapy, Bonvoisin-Gerald applicator.