Palliation of dysphagia in patients with non-curable esophageal cancer – a retrospective Danish study from a highly specialized center

Egeland, Charlotte; Bazancir, Laser Arif; Bui, Nam Hai; Bæksgaard, Lene; Gehl, Julie; Gögenür, Ismail; Achiam, Michael Patrick

doi:10.1007/s00520-022-07316-8

Cited by 1 publication

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“…For obstructive tumors, if radiotherapy is not efficient or already administered, placing an esophageal stent is the only option. As it has been shown that placing a stent might have a negative impact on survival time [ 4 , 5 , 6 ], other treatment options are warranted. As the electrode is designed today, the treatment cannot compete with an esophageal stent, as it cannot pass the tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Palliative care consists of chemotherapy or radiotherapy [ 3 ], and if the patient suffers from severe dysphagia, an esophageal stent can be placed. However, several studies, including one from our institution, indicate that placing a stent might even worsen the survival outcomes [ 4 , 5 , 6 ]. Hence, new treatment options are warranted in this vulnerable patient group.…”

Section: Introductionmentioning

confidence: 99%

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Palliative Treatment of Esophageal Cancer Using Calcium Electroporation

Egeland

Bæksgaard

Gehl

et al. 2022

Cancers

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Calcium electroporation (CaEP) is a novel cancer therapy wherein high intracellular calcium levels, facilitated by reversible electroporation, trigger tumor necrosis. This study aimed to establish safety with CaEP within esophageal cancer. Patients with non-curable esophageal cancer were included at Copenhagen University Hospital Rigshospitalet in 2021 and 2022. In an outpatient setting, calcium gluconate was injected intratumorally followed by reversible electroporation applied with an endoscopic electrode. The primary endpoint was the prevalence of adverse events, followed by palliation of dysphagia. All patients were evaluated with CT and upper endoscopies up to two months after treatment. The trial was registered at ClinicalTrials.gov (NCT04958044). Eight patients were treated. One serious adverse event (anemia, requiring a single blood transfusion) and three adverse events (mild retrosternal pain (two) and oral thrush (one)) were registered. Initially, six patients suffered from dysphagia: two reported dysphagia relief and four reported no change. From the imaging evaluation, one patient had a partial response, three patients had no response, and four patients had progression. Six months after treatment, the patient who responded well was still in good condition and without the need for further oncological treatment. CaEP was conducted in eight patients with only a few side effects. This study opens the way for larger studies evaluating tumor regression and symptom palliation.

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Section: Discussionmentioning

confidence: 99%