A male patient, aged 54, was admitted to the University Hospital for Tumors for primary radiotherapy of neoplasms in the hypopharynx and mid-esophagus, by biopsy both shown as planocellular carcinoma. Prior to initial radiation, the patient underwent 3 cycles of chemotherapy (cisplatin + 5-FU).
The main problem occurring during the radiation planning was that the target volumes of the above mentioned primary tumors were detached, making together a unique, very big volume. In addition, part of that volume was to be irradiated only electively in order to prevent microscopic disease expansion, and another smaller part required an application of the full radical tumor dose. During radiotherapy, the continuation of chemotherapy was indicated (2 cycles of cisplatin and 5-FU). Despite the large target volumes irradiated and concomitant application of chemotherapy, the patient took the entire course of primary radiochemotherapy well and without a necessary recess. The patient was discharged with his general condition improved, and at the control visit three months after the completion of radiotherapy, the diagnostic evaluation showed no signs of residual disease.Bolesnik u dobi 54 godine zaprimljen je u našu Kliniku zbog provođenja primarne radioterapije neoplazme hipofarinksa i neoplazme srednjeg dijela jednjaka. Biopsijom obje promjene dobije se planocelularni karcinom. S obzirom na isti histološki tip oba tumora, prije početka zračenja bolesnik je primio 3 ciklusa kemoterapije cisplatinom i 5-fluorouracilom.
U pripremi i planiranju zračenja temeljni problem je bio što su se ciljni volumeni odvojenih primarnih tumora doticali te su činili jedinstveni veliki volumen. Uz to, dio tog volumena valjalo je zračiti samo elektivno sa ciljem suzbijanja mikroskopske bolesti, a tek u dijelu je bilo nužno aplicirati radikalnu dozu. Tijekom zračenja određen je nastavak kemoterapije i to 2 ciklusa s cisplatinom i 5 fluorouracilom. Unatoč velikim ciljnim volumenima zračenja i konkomitantno primijenjene kemoterapije, bolesnik je dobro i u cijelosti, bez stanke u zračenju, podnio primarnu radiokemoterapiju. Otpušten je u poboljšanom općem stanju, a na prvom kontrolnom pregledu, tri mjeseca po završenoj terapiji nije bilo znakova povrata bolesti
