New developments in palliative therapy

Siersema, Peter D.

doi:10.1016/j.bpg.2006.07.005

Cited by 44 publications

(27 citation statements)

References 62 publications

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“…19 Siersema PD et al found that endoscopic placement of SEMS has become the most widely practiced treatment for palliative care, in part due to the comparatively simple technique and rapid effect on dysphagia. 20 Jiang XJ et al suggested that after stents placement, 3D-CRT could be performed as long as patient's physical condition allowed, and whenever their dysphagia was relieved, the malnutrition of the patients was ameliorated. 21 In this study, compared with the patients treated with stenting only, at least 25% of the inoperable patients after 3D-CRT survived one year, and their 6 month survival rate was also higher.…”

Section: Discussionmentioning

confidence: 99%

To study the short-term outcome of multimodality treatment on morbidity and quality of life in patients with carcinoma oesophagus

2017

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Background: Oesophageal cancer is sixth most common cause of cancer related deaths worldwide. Despite complete resections, overall survival remained low. To improve the existing treatment combination of chemotherapy and radiotherapy in both neoadjuvant and adjuvant settings was introduced. Impact of treatment on quality of life, morbidities and toxicities associated with multimodality treatment in patients of carcinoma oesophagus was studied prospectively and retrospectively.Methods: A total of 40 patients histologically proven carcinoma of the oesophagus were enrolled in the study. Study included assessment of clinical features, risk factors, biopsy, multimodality treatment and associated morbidities and toxicities. Quality of Life (QOL) in patients of multimodality treatment assessed using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Core 18 before, immediate post treatment and 6 months after completion of the planned treatment.Results: In 40 patients, male to female ratio was 1.10:1. Dysphagia was the leading complain. 3 patients were treated using neoadjuvant therapy (chemotherapy and radiotherapy followed by surgery) among them 2 patients expired, 1 patient is under regular follow up. 6 patients underwent upfront surgery followed by adjuvant therapy out of which 3 patients expired,15 patients were treated with curative intent by definitive chemotherapy and radiotherapy out of which only 7 patients survived for >1 year. 16 patients were treated with palliative intent (radiotherapy, chemotherapy, oesophageal stenting and feeding procedures) in which only 1 patient survived for 1 year.Conclusions: The present study demonstrates that patients over all QOL was reduced after treatment and in the follow up period which was due to the treatment related toxicities but in contrast symptom improvement was observed simultaneously.

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Section: Discussionmentioning

confidence: 99%

To study the short-term outcome of multimodality treatment on morbidity and quality of life in patients with carcinoma oesophagus

2017

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“…The approach of conservative versus surgical therapy in cases of iatrogenic perforation has shifted more towards conservative therapy, together with the development of novel endoscopic stenting possibilities [1] . The question of whether iatrogenic perforations are best managed by surgery or endoscopy has recently been addressed by two large studies.…”

Section: Discussionmentioning

confidence: 99%

“…Its incidence has increased most likely because of more aggressive palliative endoscopic therapy [1] , and the current widespread use of endoscopic ultrasound (EUS) for accurate preoperative staging [2] . Therapy and management, i.e.…”

Section: Introductionmentioning

confidence: 99%

Palliative cardia resection with gastroesophageal reconstruction for perforated carcinoma of the gastroesophageal junction

Gillen¹,

Frieß²,

Kleeff³

2009

WJG

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Iatrogenic perforation of esophageal cancer or cancer of the gastroesophageal (GE) junction is a serious complication that, in addition to short term morbidity and mortality, significantly compromises the success of any subsequent oncological therapy. Here, we present an 82-year-old man with iatrogenic perforation of adenocarcinoma of the GE junction. Immediate surgical intervention included palliative resection and GE reconstruction. In the case of iatrogenic tumor perforation, the primary goal should be adequate palliative (and not oncological) therapy. The different approaches for iatrogenic perforation, i.e. surgical versus endoscopic therapy are discussed.

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“…In terms of nutritional support, the most important factor is maintenance of oral food intake, which should stabilize or even improve quality of life. Dysphagia improves more rapidly after stent placement [12,13] and long-term relief of dysphagia is better after brachytherapy [24,25] . Therefore, stent placement may be reserved for esophageal cancer patients with severe dysphagia in combination with a short life expectancy who need more rapid relief of dysphagia and for patients with persistent or recurrent tumor growth after The transilluminated area on the abdominal wall was pushed with a finger; B, C: The stomach was punctured using a double-lumen gastropexy device; D: A needle with an outer plastic sheath (18-French) was introduced into the stomach under endoscopic control; E: The needle was removed and the guidewire was replaced; F, G: The skin incision was dilated by passing a dilator percutaneously into the stomach over the guidewire under endoscopic visualization; H: After the dilator was removed, a 24-French percutaneous endoscopic gastrostomy tube using an obturator was inserted over the guidewire; I: The tube was fixed to the abdominal wall.…”

Section: Outcomes Of Pegmentioning

confidence: 99%

“…These patients require palliative treatment, including brachytherapy, chemotherapy and endoscopic palliation techniques, such as esophageal dilatation, intraluminal stents and laser therapy, to relieve progressive dysphagia [12,13] . The two most commonly used strategies for improving swallowing are stent insertion and radiation, including intraluminal brachytherapy.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of percutaneous endoscopic gastrostomy for supportive therapy of advanced aerodigestive cancer

Ogino

Akiho²

2013

WJGP

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Aerodigestive cancer, like esophageal cancer or head and neck cancer, is well known to have a poor prognosis. It is often diagnosed in the late stages, with dysphagia being the major symptom. Insufficient nutrition and lack of stimulation of the intestinal mucosa may worsen immune compromise due to toxic side effects. A poor nutritional status is a significant prognostic factor for increased mortality. Therefore, it is most important to optimize enteral nutrition in patients with aerodigestive cancer before and during treatment, as well as during palliative treatment. Percutaneous endoscopic gastrostomy (PEG) may be useful for nutritional support. However, PEG tube placement is limited by digestive tract stenosis and is an invasive endoscopic procedure with a risk of complications. There are three PEG techniques. The pull/push and introducer methods have been established as standard techniques for PEG tube placement. The modified introducer method, namely the direct method, allows for direct placement of a larger button-bumper-type catheter device. PEG tube placement using the introducer method or the direct method may be a much safer alternative than the pull/push method. PEG may be recommended in patients with aerodigestive cancer because of the improved complication rate.

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New developments in palliative therapy

Cited by 44 publications

References 62 publications

To study the short-term outcome of multimodality treatment on morbidity and quality of life in patients with carcinoma oesophagus

To study the short-term outcome of multimodality treatment on morbidity and quality of life in patients with carcinoma oesophagus

Palliative cardia resection with gastroesophageal reconstruction for perforated carcinoma of the gastroesophageal junction

Usefulness of percutaneous endoscopic gastrostomy for supportive therapy of advanced aerodigestive cancer

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