EL CANCER DE ESOFAGO INOPERABLE. TRATADO CON IRRADIACION BIFRACCIONADA ACELERADA

From 1986 to 1990, 60 patients with non operable esophagic carcinoma (IEC) were treated with accelerated bifractionated irradiation (ABI) only, or after neoadjuvant chemotherapy (39 patients). Patient medium age was 62 years, the first cause of inoperability was the poor general state (32 patients). The locoregional invasion (20 patients) and the presence of a second simultaneous cancer (ORL) in 8 patients. A loss of weight up to 10% was noticed in 21 cases and 43 tumors had more than 5 cm. in size. The IBA gave, in average a total dose to tumoral bed of 66 Gy during twenty-nine days and 87% of treatments were given without interruption. We noted 12% of radiomucitis third grade, appearing during the weeks in average. For 17 patients with a tumor size less than 5 cm., the local control for two years was 70%, the specific survival 63%, and total survival was 40%. For patients with a tumor size more than 5 cm., the local control for two years was 20%, the total and specific survival was 10%. This study suggests that a accelerated bifractionated irradiation can be used for patients with (IEC) and an acceptable acute toxicity. Even though the follow-up was lower (20 to 50 months), the local control seems to be better with tumor size less than 5 cms.