Nonthermal Ablation of Malignant Esophageal Strictures: Photodynamic Therapy, Endoscopic Intratumoral Injections, and Novel Modalities

Saidi, Roxan; Marcon, Norman E.

doi:10.1016/s1052-5157(18)30273-3

Cited by 15 publications

(7 citation statements)

References 80 publications

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“…Self‐expanding metal stents are a popular means of palliation for patients with an obstructing malignancy of the esophagus or gastric cardia 1 . A wide range of other modalities have been tried 5 . These include external beam radiation therapy, brachytherapy, systemic chemotherapy, combination radiation and chemotherapy, endoscopic dilatation, photodynamic therapy, laser, contact thermal and injection ablative therapies.…”

Section: Discussionmentioning

confidence: 99%

Self-expanding metal stents in the palliation of malignant dysphagia: Outcome analysis in 100 consecutive patients*

Elphick

Smith

Bagshaw

et al. 2005

Diseases of the Esophagus

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SUMMARY. Patients with inoperable esophageal malignancy often undergo palliative self-expanding metal stent insertion. This analysis of cases shows that although such stents provide good palliation of dysphagia, complications frequently occur. Complications reported were pain after insertion, bleeding, food bolus impaction, stent migration and increased gastroesophageal reflux. Furthermore, in patients with esophageal adenocarcinoma, survival was less if the distal end of the stent entered the stomach, rather than lying entirely within the esophagus. Reduced survival, in this group with gastroesophageal junction tumors, may be a result of increased gastroesophageal reflux leading to pulmonary aspiration. Stents incorporating an antireflux valve have been shown to reduce symptomatic gastroesophageal reflux. It may be that such valves offer a survival advantage where stent insertion ablates the function of the lower esophageal sphincter. Further studies are needed to assess the role of antireflux stents on survival in patients with gastroesophageal junction tumors.

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Section: Discussionmentioning

confidence: 99%

Self-expanding metal stents in the palliation of malignant dysphagia: Outcome analysis in 100 consecutive patients*

Elphick

Smith

Bagshaw

et al. 2005

Diseases of the Esophagus

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“…This is increasingly important because of the frequent field cancerisation of this malignancy [4], and because of the very poor survival prognosis once the cancer infiltrates the submucosa of the oesophagus [10]. Fortunately PDT is an effective and safe treatment of these early malignancies [11][12][13][14], in particular for lesions on Barrett's oesophagus.…”

Section: Introductionmentioning

confidence: 99%

Assessment of a sheep animal model to optimise photodynamic therapy in the oesophagus

et al. 2009

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“…Dysphagia relief with PDT can be achieved in approximately 75% of patients. Results from randomized studies indicate that PDT can provide a similar degree of dysphagia palliation to that seen with Nd:YAG laser with fewer sessions and complications [42,43]. The disadvantages of PDT are high cost, skin photosensitivity (up to 4-6 weeks), chest pain, fever, leukocytosis, and such complications as esophageal strictures and fistulae.…”

Section: Photodynamic Therapymentioning

confidence: 99%

New approach to malignant strictures of the esophagus

Dua

2003

Curr Gastroenterol Rep

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Primary esophageal cancer is the most common cause of malignant esophageal stricture. Prognosis and treatment outcomes vary with the stage of the disease. Endoscopic ultrasound has a high accuracy rate for local and regional staging. Surgery is curative for early cancer. Endoscopic mucosal resection, photodynamic therapy, or brachytherapy can be used with curative intent for early cancer, especially in patients with comorbid conditions precluding surgery. Unfortunately, the majority of patients with esophageal cancer present with advanced disease. The primary aim in these patients is to alleviate symptoms with a minimum of side effects and reinterventions. Palliative surgery or chemoradiotherapy can be associated with high morbidity and mortality rates. Several endoscopic techniques for palliation are available, and all have the potential of significantly improving swallowing. The choice of a particular endoscopic approach is usually determined by local expertise and characteristics of the stricture.

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Nonthermal Ablation of Malignant Esophageal Strictures: Photodynamic Therapy, Endoscopic Intratumoral Injections, and Novel Modalities

Cited by 15 publications

References 80 publications

Self-expanding metal stents in the palliation of malignant dysphagia: Outcome analysis in 100 consecutive patients*

Self-expanding metal stents in the palliation of malignant dysphagia: Outcome analysis in 100 consecutive patients*

Assessment of a sheep animal model to optimise photodynamic therapy in the oesophagus

New approach to malignant strictures of the esophagus

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