Endoscopic Injection of Mitomycin C for the Treatment of Pharyngoesophageal Stenosis Refractory to Endoscopic Treatment with Dilatation in Patients Treated for Head and Neck Cancer

Background. Management of pharyngoesophageal stenosis (PES) in patients after head and neck cancer (HNC) treatment remains a challenge. It is not uncommon that PES is refractory to dilation sessions. This study aimed at evaluating the efficacy of Mitomycin C (MMC) endoscopic injection for the treatm...

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Bibliographic Details
Published in:Gastroenterology research and practice 2018-01, Vol.2018 (2018), p.1-5
Main Authors: Ribeiro Jr., Ulysses, Maluf-Filho, Fauze, Kulcsar, Marco Aurelio, Tolentino, Luciano Lenz, Martins, Bruno Costa, Uemura, Ricardo Sato, de Lima, Marcelo Simas, de Paulo, Gustavo Andrade, Kuboki, Yeda Mayumi, Gusmon-Oliveira, Carla Cristina, Safatle-Ribeiro, Adriana Vaz
Format: Article
Language:English
Subjects:
Anesthesia
Archives & records
Cancer
Cancer patients
Cancer therapies
Care and treatment
Deglutition disorders
Dysphagia
Endoscopy
Esophagus
Fibroblasts
Gastroenterology
Head & neck cancer
Head and neck cancer
Medical research
Medicine, Experimental
Mitomycin
Otolaryngology
Patients
Pediatrics
Prevention
Radiation therapy
Stenosis
Thermoplastics
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Summary:Background. Management of pharyngoesophageal stenosis (PES) in patients after head and neck cancer (HNC) treatment remains a challenge. It is not uncommon that PES is refractory to dilation sessions. This study aimed at evaluating the efficacy of Mitomycin C (MMC) endoscopic injection for the treatment of refractory pharyngoesophageal stenosis. Patients and methods. This is a prospective study in patients with dysphagia following head and neck cancer treatment, without evidence suggestive of tumor recurrence, and refractory to endoscopic treatment. These patients were submitted to endoscopic dilation of the stenotic segment with thermoplastic bougies, followed by injection of MMC. We repeated the endoscopic sessions every three weeks. Results. From January 2015 to May 2015, we treated 13 patients with PES. Three patients were initially enrolled in the study for refractory stricture. We observed adverse events in all of them, with intense neck pain and ulcer development, justifying the interruption of the trial. Conclusion. The repeated injection in the short interval of MMC in refractory PES is not recommended, because it resulted in serious adverse events.
ISSN:1687-6121
1687-630X
DOI:10.1155/2018/5428157