[Comparative evaluation of radiotherapy and chemoradiotherapy in inoperable cancer of the esophagus]. / Sravnitel'naia otsenka luchevogo i khimioluchevogo lecheniia neoperabel'nogo raka pishchevoda.

The paper is concerned with the results of radiation therapy and three variants of chemoradiotherapy of 174 patients with inoperable esophageal cancer. Altogether 151 (87%) patients were given treatment from beginning to end. Complete tumor regression was noted in 41% of the patients after chemoradiotherapy and in 29%--after radiotherapy. The 2-year survival rates were 28 and 20%, the 5-year survival rates were 8 and 0%, respectively. Among the variants of chemoradiotherapy the most effective one was the combination of 5-FU with bleomycin, in which complete tumor regression was noted in 46% of the patients, and the 2-year survival was 43% versus 25% in the combination of 5-FU with adriamycin and 21% in its combination with methotrexate. Prognostically unfavorable factors were a degree of body mass deficiency, tumor spreading and a tumor site in the esophagus.

[Endoscopic laser recanalization in the chemo- and radiotherapy of stenosing cancer of the esophagus]. / Endoskopicheskaia lazernaia rekanalizatsiia v khimioluchevom lechenii stenoziruiushchego raka pishchevoda.

The authors analyze the results of endoscopic laser recanalization in 11 patients with stenosing esophageal carcinoma, whose mean age is 61 years. The tumor was located in the upper thoracic portion of the esophagus in 3 patients, in the middle thoracic portion in 6, and in the lower thoracic portion in 2 patients. The diagnosis of carcinoma was morphologically verified. The length of the esophagus involvement was estimated by x-ray data and varied from 5 to 12 cm and longer. Endophytic form predominated--it was diagnosed in 5 patients. The technique of endoscopic laser recanalization by means of Raduga-1 unit with neodymium alumo-yttrium garnet laser as the source of irradiation is described. The method was specified with consideration for the type of tumor growth. The patients were kept on parenteral nutrition during the treatment session. Three-five days after endoscopic laser destruction long-distance open-field gamma-beam therapy was administered to 10 patients and polychemotherapy to 9 of these. After laser destruction dilatation of the stenosed portion of the esophagus from 0.2-0.6 to 1.0-2.0 cm was recorded in 10 patients. Complete regression of the tumor resultant from laser destruction and chemoradiotherapy was achieved in 5 patients, partial regression in the rest 5. The patients were followed up for 5-12 months. No recurrences were recorded in patients with complete regression of the tumor; the process progressed in 3 cases with partial regression. Studies on improvement of recanalization technique, specification of indications for and contraindications against this treatment modality are in progress.