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Daytime pulsed dose rate brachytherapy as a new treatment option for previously irradiated patients with recurrent oesophageal cancer

Department of Radiooncology, University of Heidelberg, INF 400, 69120 Heidelberg, Germany

View larger version (80K): [in a new window]   Figure 1. This image shows the oesophageal brachytherapy catheter containing a ribbon of dummy seeds. Two surgical clips (arrows) delineate the cranial and caudal extent of the oesophageal recurrence.

View larger version (13K): [in a new window]   Figure 2. Schematic drawing of the oesophageal applicator: a self-made catheter consisting of two single hollow tubes (outer tube: oesophageal tube, Rüsch GmbH, Kernen-Rommelshausen, Germany; inner tube: duodenal tube, B. Braun Melsungen AG, Melsungen, Germany), which were stuck into each other, was used for endoluminal irradiation. This approach ensured central positioning of the 6 Fr brachytherapy catheter (Nucletron, Veenendaal, The Netherlands) within the oesophageal applicator. The applicators had outer diameters ranging from 6 mm to 10 mm.

View larger version (12K): [in a new window]   Figure 3. Grade 2 (RTOG/EORTC) dysphagia-free survival after daytime pulsed dose rate (PDR) brachytherapy for re-irradiation of patients with recurrent oesophageal cancer. The endpoint of this analysis was the occurrence of grade 2 dysphagia (unable to take solid food normally, swallowing semi-solid food, dilatation may be indicated) during follow-up.