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Chemotherapy versus self-expanding metal stent as primary treatment of severe dysphagia from unresectable oesophageal or gastro-oesophageal junction cancer.
MedLine Citation:
PMID:  24268567     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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:
Yann Touchefeu; Isabelle Archambeaud; Bruno Landi; Astrid Lièvre; Céline Lepère; Philippe Rougier; Emmanuel Mitry
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-20
Journal Detail:
Title:  Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver     Volume:  -     ISSN:  1878-3562     ISO Abbreviation:  Dig Liver Dis     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100958385     Medline TA:  Dig Liver Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Institut des Maladies de l'Appareil Digestif, Gastrointestinal Oncology Unit, University Hospital, Nantes Cedex 1, France. Electronic address: yann.touchefeu@chu-nantes.fr.
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