Effect of tumour and chemoradiotherapy on oesophageal motility.
BACKGROUND
The contribution of dysmotility to dysphagia in oesophageal cancer is unclear.


OBJECTIVE
To examine oesophageal motility in patients with oesophageal carcinoma and to assess the effect of chemoradiotherapy on motility.


METHODS
Stationary manometry and 24-hour pH-metry were performed in 12 patients with oesophageal carcinoma and one week following completion of chemoradiotherapy using 5-fluorouracil (5-FU), cisplatin and 40Gy radiotherapy.


RESULTS
All patients had abnormal motility prior to treatment. Peristalsis was impaired in 11 patients with a mean (SD) of 25% (9) of waves normally propagated. Eight patients had 20% or more simultaneous waves. Following chemoradiotherapy, the percentage of waves normally propagated increased from 25% (9) to 521% (10) (p < 0.03) and normal peristalsis was restored in four patients. The percentage of simultaneous waves decreased from 38% (11) to 21.6% (10) (p = 0.129) while the percentage of dropped or increased waves decreased from 20% (11) to 8.3% (4) (p = 0.264).


CONCLUSIONS
Oesophageal motility is disturbed in oesophageal cancer. Dysphagia in oesophageal cancer may be partly explained by oesophageal dysmotility. This is improved by chemotherapy.
Tormey
S
S
RCSI Department of Surgery, James Connolly Memorial Hospital, Blanchardstown, Dublin, Ireland.
Nasyr
A
A
McNamara
D A
DA
Byrne
P J
PJ
Walsh
T N
TN
D000230:Adenocarcinoma / Q000503:physiopathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000503:physiopathology / Q000628:therapy; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000503:physiopathology*; D004938:Esophageal Neoplasms / Q000503:physiopathology* / Q000628:therapy; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D010528:Peristalsis; D011879:Radiotherapy Dosage
D002945:Cisplatin; D005472:Fluorouracil