Abstract
A method of brachytherapy treatment planning using MRI is presented. In 13 patients with inoperable squamous cell cancer of the thoracic oesophagus an intraluminal afterloading boost with MRI assistance was performed. A new type of flexible catheter was filled with 1/100 diluted Gd-DTPA and introduced into the oesophagus before performing MRI in the sagittal, coronal and transverse planes. One sagittal or coronal picture which showed the catheter tip and the residual cancer was magnified to “life size”. The position of the catheter was corrected if necessary and the treatment volume decided. The contrast medium was then aspirated out of the catheter and a thinner afterloading catheter pushed into the outer catheter. The patient was moved immediately to the afterloading room and received the first dose of boost irradiation. This method allows much more precise brachytherapy planning since it shows the cancer and the catheter together. It is superior to localising the cancer with a barium swallow or endoscopy because MRI visualises the whole extent of the residual cancer, which can then be covered with the necessary dose.
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References
Nori D, Linares L, Son Y, Philipps T (1990) Esophageal cancer: brachytherapy experience. In: Interstitial brachytherapy: physical, biological and clinical considerations. Raven Press New York, pp 141–145
Pakisch B, Kohek P, Juttner F, Stuckschweiger G, Poier E (1988) Intraluminal Ir-192 brachytherapy combined with Nd-YAG laser: a palliative treatment for malignant tumor stenoses of the upper gastrointestinal tract [abstract]. In: Seventh annual meeting of the European Society for Therapy, Radiology and Oncology, 5–8 September 1988, The Hague, p 179
Pizzi GB, Beorchia A, Gereghini ME, Contento G, Fongione S, Gugliemi R, Mandoliti G (1989) A new technique for endocavitary irradiation of the oesophagus. Int J Radiat Oncol Biol Phys 16: 261–262
Rowland CG, Pagliero KM (1985) Intracavitary irradiation in palliation of carcinoma of oesophagus and cardia. Lancet II: 981–983
Sur RK, Kochar R, Singh DP, Sharma SC, Goenka MK, Negi PS, Gupta BD, Metha SK (1991) High dose rate intracavitary therapy in advanced carcinoma esophagus. Indian J Gastroenterol 10: 43–45
Abe M, Kitagawa T (1981) Treatment of esophageal cancer with high dose rate intracavitary irradiation. Thoku J Exp Med 134: 159–167
Bader M, Dittler HJ, Ultsch B, Ries G, Siewert JR (1986) Palliative treatment of malignant stenoses of the upper gastrointestinal tract using a combination of laser and afterloading therapy. Endoscopy 18 [Suppl 1]: 27–31
Fleischmann EH, Kagan AR, Bellotti JE, Streeter OE Jr, Harvey JC (1990) Effective palliation for inoperable esophageal cancer using intensive intracavitary radiations. J Surg Oncol 44: 234–237
Hagenmüller F, Sander R, Sander R, Ries C, Classen M (1987) Palliation of obstructive oesophageal and cardial carcinomas with laser and endoluminal iridium radiation. Baillieres Clin Gastroenterol 1: 917–922
Pakisch B, Kohek P, Stucklschwaiger G, Smolle-Juttner FG, Poier E (1990) A therapeutic concept for the treatment of inoperable esophageal carcinoma. Strahlenther Onkol 166: 247–250
Petrovich Z, Langholz B, Formenti S, Luxton G, Astrahan M (1991) Management of carcinoma of the oesophagus: the role of radiotherapy. Am J Clin Oncol 14: 80–86
Shinoda M, Tagaki I, Fukushima M (1988) Prolonged survival for postoperative recurrent carcinoma of the oesophagus using radiotherapy and chemotherapy [abstract]. Proc Annu Meet Am Soc Clin Oncol 7: A409
Abitbol A, Straus MJ, Franklin G, Billet D, Sullivan P, Moran RE (1983) Infusional chemotherapy and cyclic radiation therapy in inoperable esophageal and gastric cardia carcinoma. Am J Clin Oncol 6: 195–201
Arujo CM, Souhami L, Gil RA, Carvalho R, Garcia JA, Froimtchuk MJ, Pinto LH, Canary PC (1991) A randomized trial comparing radiation therapy versus concomitant radiation therapy and chemotherapy in carcinoma of the thoracic esophagus. Cancer 57: 2258–2261
Coia L, Engstrom P, Paul A, Stafford P, Hanks G (1990) Longterm results of infusional 5-FU, Mitomycin-C and radiations as primary management of esophageal carcinoma [abstract]. In: Proceedings of the 72nd Annual American Radium Society Meeting, 21–25 April 1990, Scotsdale, AZ, p 18
Herskovic A, Martz K, Al-Sarraf M, Leichman L, Brindle JS, Vaitkevicious VK, Cooper J, Byhardt R, Davis L, Emami B (1991) Intergroup esophageal study: comparison of radiotherapy to radio-chemotherapy combination. A phase III trial [abstract]. Proc Annu Meet Am Soc Clin Oncol 10: A407
Hukku S, Fernandes P, Vasistha S, Sharma VK (1989) Radiation therapy alone and in combination with bleomycin and 5-FU in advanced carcinoma of esophagus. Indian J Cancer 26: 131–136
John MJ, Flam MS, Mowry PA, Podolsky WJ, Xavier AM, Wittlinger PS, Padmanabhan A (1989) Radiotherapy alone and chemoradiation for nonmetastatic esophageal carcinoma: a critical review of chemoradiation. Cancer 63: 2397–2493
Keane TJ, Harwood AR, Elhakim T, Rider WD, Cummings BJ, Ginsberg RJ, Cooper JC (1985) Radical radiation therapy with 5-FU infusion and Mitomycin C for oesophageal squamoss carcinoma. Radiother Oncol 4: 205–210
Lehr L, Rupp N, Siewert JR (1988) Assessment of resectability of esophageal cancer by computed tomography and magnetic resonance imaging. Surgery 103: 344–350
Halvorsen RA, Herfkins RJ, Wolfe WG, Thompson WM (1987) Comparison of magnetic resonance to computed tomography for staging esophageal carcinoma [abstract]. In: 87th annual meeting of the American Roentgen-Ray ociety, April 26–May 1 1987, Miami, FL, p 133
Krestin GP, Steinbrich W, Friedmann G, Thul P (1986) Magnetic resonance tomographic findings in esophageal cancer: RöFo 145: 437–440
Takashima S, Takeuchi N, Shiozaki H, Kobayashi K, Morimoto S, Ikezoe J, Tomijama N, Harada K, Shogen K, Kozuka T (1991) Carcinoma of the esophagus: CT vs MR imaging in determining resectability. AJR 156: 297–302
Hishikawa Y, Kamikonya N, Tanaka S, Miura T (1987) Radiotherapy of esophageal carcinoma: role of high-dose-rate intracavitary irradiation. Radiother Oncol 9: 13–20
Coia L, Engstrom PF, Paul A (1987) Nonsurgical management of esophageal cancers: report of a study of combined radiotherapy and chemotherapy. J Clin Oncol 5: 1783–1790
Fisher SA, Brady LW (1987) Radiation oncology: carcinoma of the esophagus. In: Perez CA, Brady LW (eds) Principles and practice of radiation oncology. Lippincott, Philadelphia, pp 700–722
Hyden EC, Langholz B, Tilden T, Lam K, Luxton G, Astrahan M (1988) External beam and intraluminal radiotherapy in the treatment of carcinoma of the esophagus. J Thorac Cardiovasc Surg 96: 237–241
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Aydin, H., Bachmann, G., von Lieven, H. et al. MRI-guided brachytherapy for cancer of the oesophagus. Eur. Radiol. 3, 219–222 (1993). https://doi.org/10.1007/BF00425897
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DOI: https://doi.org/10.1007/BF00425897