Malignant esophagogastric junction obstruction: efficacy of balloon dilation combined with chemotherapy and/or radiation therapy.
OBJECTIVE
To assess the efficacy of balloon dilation combined with chemotherapy and/or radiation therapy for palliation of dysphagia due to malignant esophagogastric junction strictures.


METHODS
Fluoroscopically guided balloon dilation was attempted in 20 patients. The causes of strictures were gastric adenocarcinoma (n = 10) and esophageal squamous cell carcinoma (n = 10). Scheduled chemotherapy and/or radiation therapy followed balloon dilation in all patients.


RESULTS
There were no technical failures or major complications. After balloon dilation, 15 (75%) patients showed improvement of dysphagia. No patient complained of reflux esophagitis during the follow-up period. Among the 15 patients, seven needed no further treatment for palliation of dysphagia until their deaths. The remaining eight patients underwent repeat balloon dilation (n = 4) or stent placement (n = 4) 3-43 weeks (mean 15 weeks) after the initial balloon dilation because of recurrent dysphagia.


CONCLUSIONS
Balloon dilation combined with chemotherapy and/or radiation therapy seems to be an easy and reasonably effective palliative treatment for malignant esophagogastric strictures.
Ko
Gi-Young
GY
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-Dong, Songpa-Ku, Seoul 138-736, Korea.
Song
Ho-Young
HY
Hong
Heuk-Jin
HJ
Sung
Kyu-Bo
KB
Seo
Tae-Seok
TS
Yoon
Hyun-Ki
HK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D002404:Catheterization; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology / Q000401:mortality; D004935:Esophageal Diseases / Q000401:mortality / Q000628:therapy*; D004943:Esophagogastric Junction / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D012086:Reoperation; D012720:Severity of Illness Index; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome