The management of radiation-associated oesophageal carcinoma: a report of 16 cases.

16 patients, presenting with squamous cell carcinoma in previously irradiated sections of the oesophagus, are described. Oesophagectomy could be performed in 2 patients, resulting in long-term disease-free survival (38 and 60 months after diagnosis). 14 patients were treated with palliative radiotherapy (external beam or intraluminal), oesophageal stenting, bougienage or chemotherapy. Although most patients previously received curative dosages of mediastinal irradiation, additional full courses of high-dose radiotherapy could be given on five occasions; no major complications were encountered and adequate palliation for up to 10 months was achieved. Similar results were observed after oesophageal stenting and/or bougienage. Relief of dysphagia following intraluminal radiotherapy or chemotherapy was only minimal (2 months or less). Median survival in the palliative treatment group was 6.5 months (range 2-27 months), which is in keeping with results observed in non-radiation-associated oesophageal carcinoma. We concluded that, in selected cases, both surgery and radiotherapy offer good prospects for patients with radiation-associated oesophageal cancer.