食道表在癌放射線治療著効後に照射野内に発見され内視鏡的治療で根治しえた食道粘膜癌の3例

Abstract

In general, salvage EMIR after radiotherapy (RT) is regarded as contra- indicated in esophageal cancer. We report here three cases of mucosal esophageal cancer found within the irradiated field of previous RT and treated successfu11y with EMR and local heating therapy. Case 1, a 73-year-old man, was diagnosed with operable squamous cell carcinomas (SCCs) of the esophagus (T1bN0M0: stage I). We performed radical radiotherapy (RT) of 70 Gy and the responses of these tumors were complete response (CR). Twenty-four months after RT, we found metachronous mucosal esophageal cancer within the irradiated field. Case 2, a 57-year-old man, was diagnosed with SCCs of the esophagus (T1aN0M0: stage 0). We tried to perform endoscopic mucosal resection (EMR) for the tumors, but could not resect them completely. Then, we performed additional RT of 60 Gy for the residual tumors. The tumor responses were CR. Twenty months after RT, we found recurrent mucosal esophageal cancer. Case 3, an 81-year-old man, was diagnosed with SCC of the esophagus (T1bN0M0: stage I). We performed radical RT of 60 Gy because of his advanced age, and the tumor response was CR. But 6 months after RT, we found recurrent mucosal esophageal cancer. For these mmors, we performed EMR and local heating therapy. In conclusion, these endoscopic treatments may be useful in patients with mucosal esophageal cancer within the irradiated field.