Palliation of inoperable esophageal carcinoma. Therapeutic endoscopy as an adjunct to combined chemotherapy and radiotherapy.

The combined regimen of irradiation and chemotherapy has been successfully used as a preoperative measure to improve the cure rate for squamous cell carcinoma of the esophagus. In the nonresectable patient, we have seen response to this regimen in the form of conversion of the neoplastic stricture into a fibrous one. Dysphagia remained unchanged due to the persistence of a stricture. In this situation, therapeutic endoscopy can be highly effective for relief of dysphagia, as illustrated by a case report, and is proposed as the palliative procedure of choice when the patient has shown response to combined chemotherapy and radiotherapy.