Yann Touchefeu1, Isabelle Archambeaud2, Bruno Landi3, Astrid Lièvre4, Céline Lepère3, Philippe Rougier3, Emmanuel Mitry4. 1. Institut des Maladies de l'Appareil Digestif, Gastrointestinal Oncology Unit, University Hospital, Nantes Cedex 1, France. Electronic address: yann.touchefeu@chu-nantes.fr. 2. Institut des Maladies de l'Appareil Digestif, Gastrointestinal Oncology Unit, University Hospital, Nantes Cedex 1, France. 3. Department of Gastroenterology, Hôpital européen Georges Pompidou, Paris, France. 4. Medical Oncology Department, René Huguenin Hospital, Institut Curie, Saint-Cloud, France.
Abstract
OBJECTIVE: To compare chemotherapy first (group 1) versus self-expanding metal stent first (group 2) for the management of malignant dysphagia in unresectable oesophageal or gastro-oesophageal junction cancer. METHODS: Patients from two university hospitals with severe malignant dysphagia (dysphagia score ≥ 2) uneligible for surgery or radiochemotherapy were evaluated retrospectively. RESULTS: Forty-two patients were included in group 1, and 29 in group 2. After 4 weeks, dysphagia scores improved by at least 1 point in 67% of patients in group 1 versus 93% in group 2 (p=0.01); 48% of patients in group 1 were able to eat solid food versus 68% in group 2 (p=0.054). In group 1, a self-expanding metal stent was secondarily placed in 18 patients (42.9%), whereas in group 2 dysphagia required a second self-expanding metal stent placement in 33.3% of patients. CONCLUSION: Chemotherapy as the first treatment may be a valid option, avoiding self-expanding metal stent insertion in half of the patients.
OBJECTIVE: To compare chemotherapy first (group 1) versus self-expanding metal stent first (group 2) for the management of malignant dysphagia in unresectable oesophageal or gastro-oesophageal junction cancer. METHODS:Patients from two university hospitals with severe malignant dysphagia (dysphagia score ≥ 2) uneligible for surgery or radiochemotherapy were evaluated retrospectively. RESULTS: Forty-two patients were included in group 1, and 29 in group 2. After 4 weeks, dysphagia scores improved by at least 1 point in 67% of patients in group 1 versus 93% in group 2 (p=0.01); 48% of patients in group 1 were able to eat solid food versus 68% in group 2 (p=0.054). In group 1, a self-expanding metal stent was secondarily placed in 18 patients (42.9%), whereas in group 2 dysphagia required a second self-expanding metal stent placement in 33.3% of patients. CONCLUSION: Chemotherapy as the first treatment may be a valid option, avoiding self-expanding metal stent insertion in half of the patients.
Authors: E Coron; G David; S Lecleire; J Jacques; A Le Sidaner; T Barrioz; D Coumaros; C Volteau; B Vedrenne; P Bichard; C Boustière; Y Touchefeu; J Brégeon; F Prat; M Le Rhun Journal: Endosc Int Open Date: 2016-06