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Severe complications after hypofractionated high dose rate intracavitary brachytherapy following external beam irradiation for oesophageal carcinoma

Departments of ¹ Radiology and ² Pathology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-0042, Japan

View larger version (129K): [in a new window]   Figure 1. (a) Posteroanterior and (b) lateral views of dose distributions (patient 4). Numbers indicate the total dose in per cent stemming from the application. The dose reference point is 5 mm below the oesophageal mucosa.

View larger version (158K): [in a new window]   Figure 2. Radiographic response of oesophageal cancer to external beam and intracavitary irradiation (patient 4). (a) Before therapy. (b)After therapy, the tumour has disappeared almost completely.

View larger version (85K): [in a new window]   Figure 3. CT of patient 4 shows a thin walled abscess cavity with air–fluid levels representing the connection to the bronchial system.

View larger version (119K): [in a new window]   Figure 4. Oesophagograph demonstrating the connection between the mid oesophagus and a right lower lobe bronchus (patient 5).