Stent insertion or endoluminal brachytherapy as palliation of patients with advanced cancer of the esophagus and gastroesophageal junction. Results of a randomized, controlled clinical trial

Esophageal cancer often presents as advanced stage disease with a dismal prognosis, with only 10–15% of patients surviving 5 years. Therefore, in a large proportion of patients, palliative treatment is the only option available. The aim of this study was to prospectively compare the palliative effec...

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Bibliographic Details
Published in:Diseases of the esophagus 2005-01, Vol.18 (3), p.131-139
Main Authors: Bergquist, H., Wenger, U., Johnsson, E., Nyman, J., Ejnell, H., Hammerlid, E., Lundell, L., Ruth, M.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Brachytherapy
Brachytherapy - methods
Deglutition Disorders - etiology
Deglutition Disorders - therapy
esophageal neoplasms
Esophageal Neoplasms - complications
Esophageal Neoplasms - pathology
Esophageal Neoplasms - therapy
Esophagogastric Junction
Female
Humans
Male
Neoplasm Staging
Oto-rino-laryngologi
Otorhinolaryngology
palliative care
Palliative Care - methods
Prospective Studies
Prosthesis Implantation - instrumentation
Quality of Life
Stents
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Summary:Esophageal cancer often presents as advanced stage disease with a dismal prognosis, with only 10–15% of patients surviving 5 years. Therefore, in a large proportion of patients, palliative treatment is the only option available. The aim of this study was to prospectively compare the palliative effect of self‐expandable stent placement with that of endoluminal brachytherapy regarding the effect on quality of life and on specific symptoms. Sixty‐five patients with advanced cancer of the esophagus or gastroesophageal junction were randomized to treatment with either an Ultraflex expandable stent or high‐dose‐rate endoluminal brachytherapy with 7 Gy × 3 given in 2–4 weeks. Clinical assessment and health‐related quality of life (HRQL) were measured at inclusion and 1, 3, 6, 9 and 12 months later. The HRQL was measured with standardized questionnaires (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Oesophageal Module and Hospital Anxiety and Depression Scale). Twenty‐eight patients completed the stent treatment and 24 patients the brachytherapy. The group of patients treated with stent reported significantly better HRQL scores for dysphagia (P 
ISSN:1120-8694
1442-2050
DOI:10.1111/j.1442-2050.2005.00467.x