Summary of case report
A known condition of cancer, penetrating, weak differentiation, lower esophagus, moved to the liver (foci of the liver was 1 cm) and lymph nodes in the abdomen, inguinal region and pelvis as well as the left adrenal gland, was first diagnosed with ultrasound 5/11/2018
The ultrasound of the thyroid gland, behind the left lobe of the thyroid gland, shows that the esophageal wall is thick in this segment, with a solid foci surrounding the thyroid gland and contact and continuity with the esophagus in this sector not exceeding 6 mm. The tumor pathology is confirmed in the esophagus During the sample of the lymph nodes and then the work of PET / CT, which confirmed the previous information and began chemotherapy in
11/2018 4X FLOT + Filgstrim.
At 1/2019, PET / CT was reintroduced with a separate response with decreased esophageal tumor size but isolated liver boron increased to 4 cm.
It was decided after this result to use the local radiation therapy by remote loading of the patient to treat the liver focus (planned on 29.1.2019) with the continuation of FLOT and
29.1.2019 Localized radiotherapy was performed for the post-loading technique of the liver.
The chemotherapy continued after the intervention.
Comparative ultrasound examination was done 22/2/2019
In the history of the examination, the sound waves showed the disappearance of the solid foci extending the wall of the esophagus with the reduction of the thickness of the wall from 4,5 mm to 3.5 mm and showed the survival of the cancerous glands located on the collarbone and the other glands by the neck, without development, which means that chemotherapy stopped the spread of the tumor in this the range.
As for the liver, the examination showed the presence of two foci in the right lobe of the liver, the focus of the front and back, which are located on the outside which is the front of the complex nature is solid and contains parts decomposed / sachet which indicates the lack of cancer activity despite the large size to
6 × 6 × 4.5 cm compared with 4.5 cm as was explained in PET / CT on 29.01.2019, and the other lens solid and show its nature increase the sound echo emitted with the absence of internal blood vessels almost and not random this awareness which indicates that .. Pool Blood or inactive pores … often arose during radiation therapy after its way after loading the local radiation brachytherapy to the point of the liver
As for the lymph nodes, many lymph nodes around the arterial artery, between the lower valvular vein and the aortic artery, around the pancreas and other places of lymphatic glands in the abdomen and pelvis are still present in a more intense volume, and activity, which is an increase in the load of the tumor transmitted to the lymph nodes . ..
About Radiation Therapy
Localized radiation therapy (BT / Brachytherapy) and external radiation therapy (EBRT / External Beam Radiotherapy) are two types of radiation techniques used. In local radiotherapy, the radiation device is placed inside or near the target size of any tumor. EBRT is used as a device located at a distance from the patient and has low exposure to radiation unlike BT K. Over the past three decades, there has been renewed interest in the use of BT. The discovery of man-made radioactive isotopes and remote loading techniques has reduced the risk of exposure to radiation. Innovative imaging techniques (computed tomography, magnetic resonance imaging, cross-rectal ultrasound) and sophisticated computerized processing planning systems have helped to increase the accuracy of positioning and optimal dose distribution.

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