Onkologie. 2012:6(6):328-332

Locally advanced esophageal cancer - multidisciplinar management - personal experience

Milada Zemanová¹, Pavel Vítek², Martina Vašáková³, Aleš Novotný⁴, Eva Maisnerová⁴

¹ Onkologická klinika 1. LF UK a VFN, Praha

² Ústav radiační onkologie Nemocnice Na Bulovce, Praha

³ Pneumologická klinika 1. LF UK a TN, Praha

⁴ IV. interní klinika 1. LF UK a VFN, Praha

Esophageal cancer is characterized by 90 % mortality. Nevertheless, the part of the patients suffering from locally advanced disease can

survive for a long time thanks to the multidisciplinar treatment. This fact can be documenetd by this case report of 40 year old man with

squamous cell carcinoma of medial oesophagus intergrowing to respiratory tract, stage T4N1M0. At the start of the treatment Dumon

Y stent was introduced into airways to avoid suffocation. Then, the concurrent chemoradiotherapy was used, with the radiation dose

of 66Gy/33 fractions/47 days. Chemotherapy using combinationof cisplatin and fluorouracil was administered in the total length of 6

cycles, with the radiation applied during the second and third cycle. After the treatment, CT revealed the partial regression of the tumor,

while endoscopic biopsies from oesophagus and bronchial tubes being negative for malignancy. During the first year after the chemoradiotherapy

the tight stenosis of the oesophagus with the total aphagia was to be solved using the repeated dilatations. During the

following period, the illness course was complicated by endobronchial granulations, treated by the local laser treatment and mechanical

ablation, as well. Repeated biopsies shown the local endobronchial progression of the tumor, so that the paliative chemotherapy

with the docetaxel was applicated, lasting one-year. During this period, repeated endobronchial biopsies did not proved a malignancy,

CT finding was normalized and the patient´s status was improved. Finally, the Y stent was removed 25 months after insertion, and the

chemotherapy was ended. Three years after the diagnosis, the patient had no signs of the tumor recurrence.

Keywords: esophageal cancer, multidisciplinar management, concurrent chemoradiotherapy, cisplatin, fluorouracil, docetaxel

Published: December 1, 2012  Show citation