International Journal of Clinical Oncology

, Volume 17, Issue 3, pp 263–271 | Cite as

Long-term outcomes of intraluminal brachytherapy in combination with external beam radiotherapy for superficial esophageal cancer

  • Yuji Murakami
  • Yasushi Nagata
  • Ikuno Nishibuchi
  • Tomoki Kimura
  • Masahiro Kenjo
  • Yuko Kaneyasu
  • Tomoyuki Okabe
  • Yasutoshi Hashimoto
  • Yukio Akagi
Original Article



The aim of this study was to assess the long-term outcomes of combining high-dose-rate intraluminal brachytherapy (IBT) with external beam radiotherapy (EBRT) for superficial esophageal cancer (SEC).


From 1992 to 2002, 87 patients with T1N0M0 thoracic esophageal cancer received IBT in combination with EBRT. Of these, 44 had mucosal cancer and 43 had submucosal cancer. For patients with tumor invasion within the lamina propria mucosa, IBT alone was performed (n = 27). IBT boost following EBRT was performed for patients with tumor invasion in the muscularis mucosa or deeper (n = 60). No patient received chemotherapy.


The median follow-up time was 94 months. For mucosal cancer, the 5-year locoregional control (LRC), cause-specific survival (CSS) and overall survival (OS) rates were 75, 97 and 84%, respectively, and 49, 55 and 31%, respectively, for submucosal cancer. Tumor depth was a significant factor associated with LRC (p = 0.02), CSS (p < 0.001) and OS (p < 0.001) by univariate analysis. Multivariate analysis revealed that tumor depth was the only significant predictor for OS (p = 0.003). Late toxicities of grade 3 or higher in esophagus, pneumonitis, pleural effusion and pericardial effusion were observed in 5, 0, 0 and 1 patients, respectively. Grade ≥3 events of cardiac ischemia and heart failure after radiotherapy were observed in 9 patients, and history of heart disease before radiotherapy was the only significant factor (p = 0.002).


There was a clear difference in outcomes of IBT combined with EBRT between mucosal and submucosal esophageal cancers. More intensive treatment should be considered for submucosal cancer.


Esophageal cancer Superficial esophageal cancer Squamous cell carcinoma Radiotherapy Brachytherapy 


Conflict of interest

No author has any conflict of interest.


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Copyright information

© Japan Society of Clinical Oncology 2011

Authors and Affiliations

  • Yuji Murakami
    • 1
  • Yasushi Nagata
    • 1
  • Ikuno Nishibuchi
    • 1
  • Tomoki Kimura
    • 1
  • Masahiro Kenjo
    • 1
  • Yuko Kaneyasu
    • 1
  • Tomoyuki Okabe
    • 2
  • Yasutoshi Hashimoto
    • 3
  • Yukio Akagi
    • 4
  1. 1.Department of Radiation OncologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
  2. 2.Department of RadiologyHiroshima City HospitalHiroshimaJapan
  3. 3.Department of RadiologyChugoku Rosai General HospitalKureJapan
  4. 4.Hiroshima Heiwa ClinicHiroshimaJapan

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