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. 1996 Sep;78(5):457–462.

Palliation of malignant dysphagia: an alternative to surgery.

R Mason 1
PMCID: PMC2502938  PMID: 8881732

Abstract

This paper presents the results of palliative treatment of 474 patients with malignant dysphagia. Laser produces good relief of symptoms but requires frequent repetition. Self-expanding metal stents provide one-off relief of dysphagia but do have complications. A randomised trial of laser versus covered and uncovered metal stents has demonstrated improved relief of dysphagia of stents over laser, but highlighted the problems at the cardia when stents are used. Chemotherapy in patients with advanced adenocarcinoma using epirubicin, cisplatin and 5-fluorouracil produces a response in two-thirds of cases, with relief of dysphagia and possible increase in survival. A treatment plan for palliation of patients with malignant dysphagia is presented.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alderson D., Wright P. D. Laser recanalization versus endoscopic intubation in the palliation of malignant dysphagia. Br J Surg. 1990 Oct;77(10):1151–1153. doi: 10.1002/bjs.1800771023. [DOI] [PubMed] [Google Scholar]
  2. Bown S. G. Palliation of malignant dysphagia: surgery, radiotherapy, laser, intubation alone or in combination? Gut. 1991 Aug;32(8):841–844. doi: 10.1136/gut.32.8.841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Earlam R., Cunha-Melo J. R. Oesophageal squamous cell carcinoma: I. A critical review of surgery. Br J Surg. 1980 Jun;67(6):381–390. doi: 10.1002/bjs.1800670602. [DOI] [PubMed] [Google Scholar]
  4. Gill P. G., Jamieson G. G., Denham J., Devitt P. G., Ahmad A., Yeoh E., Jones A. M. Treatment of adenocarcinoma of the cardia with synchronous chemotherapy and radiotherapy. Br J Surg. 1990 Sep;77(9):1020–1023. doi: 10.1002/bjs.1800770922. [DOI] [PubMed] [Google Scholar]
  5. Highley M. S., Hill M. E., Ziras N., Samandas N., Mason R. C., Owen W., Dussek J., Barker S., Harper P. G. High-dose folinic acid with 5-fluorouracil bolus and continuous infusion in the treatment of advanced gastric and oesophageal adenocarcinoma. Br J Cancer. 1993 Feb;67(2):407–408. doi: 10.1038/bjc.1993.75. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Highley M. S., Parnis F. X., Trotter G. A., Houston S. J., Penson R. T., Harper P. G., Mason R. C. Combination chemotherapy with epirubicin, cisplatin and 5-fluorouracil for the palliation of advanced gastric and oesophageal adenocarcinoma. Br J Surg. 1994 Dec;81(12):1763–1765. doi: 10.1002/bjs.1800811218. [DOI] [PubMed] [Google Scholar]
  7. Knyrim K., Wagner H. J., Bethge N., Keymling M., Vakil N. A controlled trial of an expansile metal stent for palliation of esophageal obstruction due to inoperable cancer. N Engl J Med. 1993 Oct 28;329(18):1302–1307. doi: 10.1056/NEJM199310283291803. [DOI] [PubMed] [Google Scholar]
  8. Loizou L. A., Grigg D., Atkinson M., Robertson C., Bown S. G. A prospective comparison of laser therapy and intubation in endoscopic palliation for malignant dysphagia. Gastroenterology. 1991 May;100(5 Pt 1):1303–1310. [PubMed] [Google Scholar]
  9. Mason R. C., Bright N., McColl I. Palliation of malignant dysphagia with laser therapy: predictability of results. Br J Surg. 1991 Nov;78(11):1346–1347. doi: 10.1002/bjs.1800781125. [DOI] [PubMed] [Google Scholar]
  10. Miller A. B., Hoogstraten B., Staquet M., Winkler A. Reporting results of cancer treatment. Cancer. 1981 Jan 1;47(1):207–214. doi: 10.1002/1097-0142(19810101)47:1<207::aid-cncr2820470134>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  11. Müller J. M., Erasmi H., Stelzner M., Zieren U., Pichlmaier H. Surgical therapy of oesophageal carcinoma. Br J Surg. 1990 Aug;77(8):845–857. doi: 10.1002/bjs.1800770804. [DOI] [PubMed] [Google Scholar]
  12. Rankin S., Mason R. Staging of oesophageal carcinoma. Clin Radiol. 1992 Dec;46(6):373–377. doi: 10.1016/s0009-9260(05)80681-6. [DOI] [PubMed] [Google Scholar]
  13. Sargeant I. R., Loizou L. A., Tobias J. S., Blackman G., Thorpe S., Bown S. G. Radiation enhancement of laser palliation for malignant dysphagia: a pilot study. Gut. 1992 Dec;33(12):1597–1601. doi: 10.1136/gut.33.12.1597. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Tyrrell M. R., Trotter G. A., Adam A., Mason R. C. Incidence and management of laser-associated oesophageal perforation. Br J Surg. 1995 Sep;82(9):1257–1258. doi: 10.1002/bjs.1800820933. [DOI] [PubMed] [Google Scholar]
  15. Watkinson A., Ellul J., Entwisle K., Farrugia M., Mason R., Adam A. Plastic-covered metallic endoprostheses in the management of oesophageal perforation in patients with oesophageal carcinoma. Clin Radiol. 1995 May;50(5):304–309. doi: 10.1016/s0009-9260(05)83421-x. [DOI] [PubMed] [Google Scholar]

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