[Radio-chemotherapy for non-resectable primary esophageal malignant melanoma].

Aim: to demonstrate the simultaneous radio-chemotherapy of primary esophageal malignant melanoma on the basis of one case.

Patient And Methods: 68-years-old male patient with malignant melanoma in middle part of the esophagus. The therapy was started with intraluminal high-dose-rate afterloading brachytherapy for the recanalisation of the esophagus (8 Gy in 0.5 cm deep), followed by percutaneous megavolt therapy two weeks after the last HDR AL session (50 Gy total dose, 5 x 2 Gy/week fractions for 5 week, 3D conformal planning). The chemotherapy was started simultaneously with the percutaneous megavolt irradiation (three courses of Cisplatin-5-Fluorouracil combination, repeated in four-week intervals). After the radio-chemotherapy a supraclavicular metastasis was verified, so the radio-chemotherapy was followed with megavolt therapy of the metastasis at 30 Gy dose (5 x 2 Gy/week fractions), and chemotherapy (Cisplatin-Dacarbazine combination in 6-session, four-week intervals) and after them immunotherapy was started.

Results: The swallow function has been improved, the supraclavicular metastasis was in partial remission. After the beginning of the radio-chemotherapy the swallow function was good for 16 months, and 18 months after the beginning of radio-chemotherapy the patient died due to pulmonary and hepatic dissemination.

Conclusion: Radio-chemotherapy of esophageal malignant melanoma has favorable palliative effect with acceptable quality of life.