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01.03.2012 | Original Research

Palliative Stenting With or Without Radiotherapy for Inoperable Esophageal Carcinoma: A Randomized Trial

verfasst von: Amit Javed, Sujoy Pal, Nihar Ranjan Dash, Vineet Ahuja, Bidhu Kalyan Mohanti, Sreenivas Vishnubhatla, Peush Sahni, Tushar Kanti Chattopadhyay

Erschienen in: Journal of Gastrointestinal Cancer | Ausgabe 1/2012

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Abstract

Background

A majority of patients with esophageal cancer present with inoperable disease and require rapid and long-lasting palliation of dysphagia.

Study aim

To compare the duration of relief of dysphagia in patients with inoperable esophageal cancer treated with esophageal stenting alone or a combination of esophageal stenting and external beam radiotherapy (EBRT), and to assess overall survival, treatment-related complications, and quality of life (QOL) in the two groups.

Patients and methods

Patients with inoperable esophageal cancer and with high grade dysphagia were randomized to receive esophageal stenting with self-expandable metal stent (Ultraflex) alone (Group I), versus a combination of stenting followed by EBRT (30 gray in ten divided fractions over 2 weeks) (Group II). Dysphagia relief, overall survival, QOL (using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30, version 3), and treatment-related complications were assessed in the two groups.

Results

From April 2007 to March 2009, 84 patients were randomized to receive esophageal stent alone (42 patients) or a combination of stent and EBRT (42 patients). The two groups were comparable in demographics, tumor characteristics, indications for palliative treatment, and pretreatment dysphagia score. Dysphagia scores improved significantly in both groups following stent insertion. However, dysphagia relief was more sustained in Group II than in Group I (7 vs. 3 months, p = 0.002). Overall median survival was significantly higher in Group II than in Group I (180 vs. 120 days, p = 0.009). Addition of radiotherapy following stenting prolonged the mean dysphagia-free survival (118.6 ± 55.8 vs. 96.8 ± 43.0 days, p = 0.054). There was significant improvement in all QOL parameters at 1 week after stenting. The QOL, however, significantly declined immediately after radiotherapy. There was no treatment-related mortality, and the incidence of complications was similar in the two groups.

Conclusion

Post-stenting EBRT effectively prolongs duration of dysphagia relief and improves overall survival in inoperable esophageal cancer.

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Titel: Palliative Stenting With or Without Radiotherapy for Inoperable Esophageal Carcinoma: A Randomized Trial
verfasst von: Amit Javed
Sujoy Pal
Nihar Ranjan Dash
Vineet Ahuja
Bidhu Kalyan Mohanti
Sreenivas Vishnubhatla
Peush Sahni
Tushar Kanti Chattopadhyay
Publikationsdatum: 01.03.2012
Verlag: Springer US
Erschienen in: Journal of Gastrointestinal Cancer / Ausgabe 1/2012
Print ISSN: 1941-6628
Elektronische ISSN: 1941-6636
DOI: https://doi.org/10.1007/s12029-010-9206-4

Springer Medizin

Palliative Stenting With or Without Radiotherapy for Inoperable Esophageal Carcinoma: A Randomized Trial