Aim & Objective: To report the toxicity and outcome of intraluminal brachytherapy(ILBT) boost following chemoradiation (CRT) in the radical treatment of patients with Squamous cell carcinoma of the esophagus.

Patients & Methods: Patients with non-metastatic squamous cell carcinoma of the esophagus who were not candidates for surgery, were enrolled for this prospective observational study. They were treated with external radiation (44 Gy in 2Gy/day) with concurrent weekly cisplatin and 5-fluorouracil followed by brachytherapy boost. Acute and late toxicities, local control and overall survival were analyzed.

Result: Thirty patients with mean age of 53 years were enrolled in this study. Mean length of esophagus involved was 6cm. Two (6.6%) patients experienced grade 3 event – esophagitis, while 4(13.3%) patients developed esophageal perforation, of which 2 patients had gross residual disease, while two patients were locally disease free. Two patients (6.6%)died due to treatment related causes – esophageal perforation. Three (10%)patients developed grade3 stricture and symptomatic ulcers which required serial esophageal dilatation. Complete response as assessed at 3 months was 76.6%. The disease free survival and the overall survival at 1 year was 65.4% and 74.8% respectively.

Conclusion: In patients with Squamous cell carcinoma of the esophagus, radical chemoradiation with brachytherapy boost is well tolerated, with low incidence of severe complications and offers good survival.

Keywords: Esophageal neoplasms, Chemoradiotherapy, Brachytherapy, Squamous cell carcinoma.

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Dr Arun Sankar Sudha, MD

Division of Radiation oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India

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