Endoscopic US in the staging of esophageal and gastric cancer

Article Abstract:

Esophageal and gastric (stomach) cancers are usually not discovered until late in their progression and the prognosis for most patients diagnosed with either is usually poor. Surgical treatment provides the best chance for a cure. Before surgery is decided upon, patients are evaluated to determine the stage of the cancer and the areas to which it has spread. This evaluation is important for determining both whether surgery would be of any value to the patient and if so, how aggressive the surgery should be. Computed tomography (CT), a scanning X-ray technique that uses a computer to produce detailed images, is commonly used to evaluate these types of cancer. In the November 1991 issue of Radiology, Botet et al. report on the use of endoscopic ultrasonography (EUS) for evaluating esophageal and gastric cancers. Endoscopic ultrasonography uses a high-frequency transducer fitted to an endoscope, a flexible instrument for viewing the body's cavities, to produce images of internal organs. EUS was shown to be very useful in evaluating these types of cancer. It gave more detailed information than CT on the extent of cell wall invasion and malignancy in lymph nodes, both of which are important for cancer staging. There were some factors in the experiment design that favored EUS, mainly pertaining to patient selection, but the results were extremely encouraging nevertheless. The results of this study, combined with the fact the EUS is fairly simple to perform and is safe, indicate it is likely to be used in staging esophageal and gastric cancers in the future. (Consumer Summary produced by Reliance Medical Information, Inc.)

Editorial, Ultrasound imaging, Diagnosis, Stomach cancer, Endoscopy

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Small, superficial esophageal carcinoma treated with high-dose-rate intracavitary irradiation only

Article Abstract:

Six patients with small cancers on the surface of the esophagus (passageway between the throat and the stomach) were treated by placing a cobalt source (CO-60) within the cavity of the esophagus. All patients underwent this treatment twice a week for two weeks (a total dose of 18- 24 Gy). The tumor in all patients had completely disappeared when the first endoscopic examination was made (a periscope-like instrument that allows the physician to see within the esophagus). Local ulcers, a response to the radiation therapy, were found in three of the patients. Five of the six patients remained free of disease for periods ranging from six to sixteen months following their irradiation. One patient, however, demonstrated a local recurrence of the tumor seven months following radiation therapy. Although the follow-up period is very short the authors believe that the treatment is effective against small, superficial cancers of the esophagus. The procedure is considerably less disabling than a radical excision and could be a valuable treatment method if follow-up establishes the long-term success of the technique.

Case studies, Radiation, Radiotherapy, Dosage and administration, Endoscopes

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Computed tomographic findings of nasopharyngeal carcinoma with skull base and intracranial involvement

Article Abstract:

Nasopharyngeal carcinoma (NPC), a cancerous tumor that occurs in the back of the nasal cavity, is not easily accessible for clinical evaluation. Computed tomography (CT) provides a method for the examination of this area, but the interpretation of these findings remains a challenge. To evaluate the usefulness of CT in the diagnosis and staging of nasopharyngeal carcinoma, 61 patients were examined by CT. In 29 of those patients, the NPC had invaded the surrounding bone. In four cases, the standard classification system did not indicate bone involvement, but such involvement was observed on the CT. Bone involvement was more readily observed on the CT than conventional radiographs. Computed tomography is clearly useful in the diagnosis of nasopharyngeal carcinoma and the evaluation of spread and bone involvement. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cancer, Tomography, Nose cancer

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