Esophageal Palliation—Photodynamic Therapy/Stents/Brachytherapy

Christie, Neil A.; Patel, Amit N.; Landreneau, Rodney J.

doi:10.1016/j.suc.2005.02.001

Cited by 12 publications

(5 citation statements)

References 33 publications

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“…Although effective, particularly in the case of PDT, 22 availability and expertise may be variable outside of regional centers. 23 We believe that effective local care is important to this group of terminally ill and frequently frail patients. Recent trials have compared SEMS with locally introduced radiotherapy, or brachytherapy.…”

Section: Discussionmentioning

confidence: 99%

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Ten-year experience of esophageal self-expanding metal stent insertion at a single institution

Stewart

Balamurugan

Everitt³

et al. 2012

Dis Esophagus

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Palliation of malignant dysphagia can be achieved using self-expanding metal stents (SEMS). This study was conceived to confirm that the insertion of SEMS improved patient symptoms without serious complications and to allow comparison with recent national data. Retrospective case note review of all patients receiving SEMS over a 10-year period between March 1999 and February 2009 was used in this study. There were 138 consecutive patients (50 female), median age of 75 (range 46-90) years, 122 (88.5%) had primary malignant disease of the esophagus or gastroesophageal junction. In total, 250 endoscopic examinations were carried out, with 200 interventional procedures, including the insertion of 156 SEMS. Before stenting, 74.2% of patients had a dysphagia score of 2-3. Following stent insertion, dysphagia scores improved to 0-1 in 90.3% of patients (P < 0.0001, Wilcoxon signed ranks). No complications were encountered in 61 (44%) patients. Chest pain was the most frequent difficulty, encountered in 50 (36%) patients. Tumor overgrowth occurred in 17 (12.3%) patients and food bolus obstruction was seen in 7% of patients. There were no esophageal perforations attributable to SEMS insertion. Overall 30-day mortality for those with esophago-gastric malignancy was 11.6% (16 patients), although the SEMS-related mortality was 2.2% (3 patients). Median survival from SEMS insertion was 3 (IQR 1.5-7) months. Patients requiring re-intervention for tumor overgrowth had a significantly longer median survival of 9.2 months (P= 0.001, log rank). SEMS were well tolerated with overall mortality and complication rates comparable to national data. For the longer survivors, re-intervention for recurrent dysphagia was not unusual.

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Section: Discussionmentioning

confidence: 99%

“…More recent options include APC and PDT, both of which often require multiple treatments. Although effective, particularly in the case of PDT, 22 availability and expertise may be variable outside of regional centers 23 . We believe that effective local care is important to this group of terminally ill and frequently frail patients.…”

Section: Discussionmentioning

confidence: 99%

Ten-year experience of esophageal self-expanding metal stent insertion at a single institution

Stewart

Balamurugan

Everitt³

et al. 2012

Dis Esophagus

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“…Additionally, chemotherapy, radiation therapy, brachytherapy, direct ethanol injection, endoscopic intubation or stenting, and palliative surgery have all been utilized in the treatment of OC not amenable to resection (87)(88)(89)(90)(91)(92). The simple fact that so many options exist would certainly seem to imply that there is no clear consensus on the most effective palliative technique.…”

Section: Treatment With Palliative Intentmentioning

confidence: 99%

Oesophageal cancer: an overview of a deadly disease

Re¹,

Parker²

2009

Ann Afr Surg.

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“…We wait for 48 hours from photosensitizer injection to administration of light therapy because tumor cells need time to selectively retain more photosensitizer than normal tissue due to differences in cancerous tissue vascular supply and lymphatic drainage [6]. After 48 hours, the patient is lightly sedated and upper endoscopy or flexible bronchoscopy is performed.…”

Section: Photosensitizer and Pdt Administration In Generalmentioning

confidence: 99%

Role of photodynamic therapy in unresectable esophageal and lung cancer

2006

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The incidence of esophageal cancer has increased dramatically in the Western population in the last two decades. Many of these patients tend to present late in the disease course with symptoms of dysphagia and malnutrition. Thus a majority of patients at presentation may require palliation of their symptoms. Lung cancer is the most common cause of cancer related mortality in the United States. Similar to esophageal cancer, many patients present in advanced stages where surgical resection for cure may not be an option. Endobronchial obstruction from both primary and metastatic neoplasm causes significant morbidity. The modalities, which are currently available for palliation of symptoms include surgery, photodynamic therapy, dilation, external beam radiation, stents, Nd:YAG laser therapy, and brachytherapy. Each of these modalities has their specific advantages and drawbacks. In this article, we discuss the role of photodynamic therapy in the palliation of esophageal and lung cancer.

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Esophageal Palliation—Photodynamic Therapy/Stents/Brachytherapy

Cited by 12 publications

References 33 publications

Ten-year experience of esophageal self-expanding metal stent insertion at a single institution

Ten-year experience of esophageal self-expanding metal stent insertion at a single institution

Oesophageal cancer: an overview of a deadly disease

Role of photodynamic therapy in unresectable esophageal and lung cancer

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