Malignant esophagogastric junction obstruction: efficacy of balloon dilation combined with chemotherapy and/or radiation therapy

Cardiovasc Intervent Radiol. 2003 Mar-Apr;26(2):141-5. doi: 10.1007/s00270-002-1510-3. Epub 2003 Mar 6.

Abstract

Purpose: 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.

Conclusion: Balloon dilation combined with chemotherapy and/or radiation therapy seems to be an easy and reasonably effective palliative treatment for malignant esophagogastric strictures.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Vessel Prosthesis
  • Catheterization
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Deglutition Disorders / etiology
  • Deglutition Disorders / mortality
  • Esophageal Diseases / mortality
  • Esophageal Diseases / therapy*
  • Esophagogastric Junction / surgery*
  • Female
  • Follow-Up Studies
  • Gastric Outlet Obstruction / mortality
  • Gastric Outlet Obstruction / therapy*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Postoperative Complications / surgery
  • Radiotherapy, Adjuvant
  • Recurrence
  • Reoperation
  • Severity of Illness Index
  • Stents
  • Survival Analysis
  • Treatment Outcome