Endoscopic Nd-YAG laser therapy as palliative treatment for esophageal and cardial cancer.
OBJECTIVE
Progressive dysphagia is the most important symptom in inoperable cases of carcinoma of the esophagus and cardia. Treatment for the relief of dysphagia is chosen based on the lowest mortality and morbidity. This paper describes alpha consecutive series of patients with esophageal or cardial cancer, without a documented tracheoesophageal fistula, who were referred for palliative laser therapy. Alternative palliative treatments are discussed, as well as factors involved in successful laser treatment.


METHODS
Over a five year period, 104 patients were treated endoscopically with the Nd-YAG laser for symptomatic improvement dysphagia caused by malignant tumors of the esophagus or cardia.


RESULTS
After the initial laser therapy, good improvement was achieved in 78 patients (75%) and fair improvement in 17 patients (16%). Eighty-three patients with significant improvement were followed until death. In 42 of these 83 patients, the initial laser therapy was the only treatment given; the remaining 41 patients required either additional laser treatment or other palliative therapy.


CONCLUSIONS
Laser treatment for palliation in esophageal and cardial cancer is promising. Given the proper circumstances, it may lay the framework for many other important treatment modalities.
Freitas
D
D
Department of Gastroenterology, University Hospital of Coimbra, Portugal.
Gouveia
H
H
Sofia
C
C
Cabral
J P
JP
Donato
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D004938:Esophageal Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome