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Published in: Digestive Diseases and Sciences 2/2012

01-02-2012 | Original Article

Factors Affecting the Success of Endoscopic Bougia Dilatation of Radiation-Induced Esophageal Stricture

Authors: Yaşar Tuna, Erdem Koçak, Dinç Dinçer, Seyfettin Köklü

Published in: Digestive Diseases and Sciences | Issue 2/2012

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Abstract

Aims

The purpose of this retrospective study was to assess clinical outcomes of endoscopic bougie dilation of esophageal strictures after radiation therapy for head and neck cancer, and to assess the risk factors which affect the treatment success.

Methods

Thirty-one patients with esophageal stricture due to radiation therapy were treated with endoscopic bougie dilation. The following parameters were evaluated; age, gender, primary site of the tumor, initial treatment of the tumor, prescribed dose of radiation, the time to onset of esophageal stricture after radiation therapy, grade of esophageal stricture according to clinical and endoscopic findings, number of dilatations, recurrence of esophageal stricture, and the result of the therapy.

Results

The average follow-up was 26 months with a range of 1–84 months. Successful endoscopic bougie dilation was achieved in 26 of 31 patients. The median time to onset of esophageal stricture after radiation therapy was significantly shorter in patients who did not respond to endoscopic bougie dilation.

Conclusion

Endoscopic bougie dilation is a safe and effective procedure for the management of radiatio- induced esophageal stricture. Time to onset of esophageal stricture is the most important factor for the treatment success. In addition, the total prescribed dosage of radiation has minimal effects on the result of endoscopic bougie dilation.
Literature
1.
go back to reference Browman GP, Hodson DI, Mackenzie RJ, Bestic N, et al. Cancer care ontario practice guideline initiative head and neck cancer disease site group. Choosing a concomitant chemotherapy and radiotherapy regimen for squamous cell head and neck cancer: a systematic review of the published literature with subgroup analysis. Head Neck. 2001;23:579–589.PubMedCrossRef Browman GP, Hodson DI, Mackenzie RJ, Bestic N, et al. Cancer care ontario practice guideline initiative head and neck cancer disease site group. Choosing a concomitant chemotherapy and radiotherapy regimen for squamous cell head and neck cancer: a systematic review of the published literature with subgroup analysis. Head Neck. 2001;23:579–589.PubMedCrossRef
2.
go back to reference Allen AM, Elshaikh M, Worden FP, Bradford CR, et al. Acceleration of hyperfractionated chemoradiation regimen for advanced head and neck cancer. Head Neck. 2007;29:137–142.PubMedCrossRef Allen AM, Elshaikh M, Worden FP, Bradford CR, et al. Acceleration of hyperfractionated chemoradiation regimen for advanced head and neck cancer. Head Neck. 2007;29:137–142.PubMedCrossRef
3.
go back to reference Laurell G, Kraepelien T, Mavroidis P. Stricture of the proximal esophagus in head and neck carcinoma patients after radiotherapy. Cancer. 2003;97:1693–1700.PubMedCrossRef Laurell G, Kraepelien T, Mavroidis P. Stricture of the proximal esophagus in head and neck carcinoma patients after radiotherapy. Cancer. 2003;97:1693–1700.PubMedCrossRef
4.
go back to reference Ahn SJ, Kahn D, Zhou S, Yu X, et al. Dosimetric and clinical predictors for radiation-induced esophageal injury. Int J Radiat Oncol Biol Phys. 2005;61:335–347.PubMedCrossRef Ahn SJ, Kahn D, Zhou S, Yu X, et al. Dosimetric and clinical predictors for radiation-induced esophageal injury. Int J Radiat Oncol Biol Phys. 2005;61:335–347.PubMedCrossRef
5.
go back to reference Ahlawat S, Al-Kawas F. Endoscopic management of upper esophageal strictures after treatment of head and neck malignancy. Gastrointest Endosc. 2008;68:19–24.PubMedCrossRef Ahlawat S, Al-Kawas F. Endoscopic management of upper esophageal strictures after treatment of head and neck malignancy. Gastrointest Endosc. 2008;68:19–24.PubMedCrossRef
6.
go back to reference Dhir V, Vege SS, Mohandas KM, Desai DC. Dilation of proximal esophageal strictures following therapy for head and neck cancer: experience with savary gilliard dilators. J Surg Oncol. 1996;63:187–190.PubMedCrossRef Dhir V, Vege SS, Mohandas KM, Desai DC. Dilation of proximal esophageal strictures following therapy for head and neck cancer: experience with savary gilliard dilators. J Surg Oncol. 1996;63:187–190.PubMedCrossRef
7.
go back to reference Swaroop VS, Desai DC, Mohandas KM, Dhir V, et al. Dilation of esophageal strictures induced by radiation therapy for cancer of the esophagus. Gastrointest Endosc. 1994;40:311–315.PubMedCrossRef Swaroop VS, Desai DC, Mohandas KM, Dhir V, et al. Dilation of esophageal strictures induced by radiation therapy for cancer of the esophagus. Gastrointest Endosc. 1994;40:311–315.PubMedCrossRef
8.
go back to reference Mavroidis P, Laurell G, Kraepelien T, Fernberg JO, et al. Determination and clinical verification of dose–response parameters for esophageal stricture from head and neck radiotherapy. Acta Oncol. 2003;42:865–881.PubMedCrossRef Mavroidis P, Laurell G, Kraepelien T, Fernberg JO, et al. Determination and clinical verification of dose–response parameters for esophageal stricture from head and neck radiotherapy. Acta Oncol. 2003;42:865–881.PubMedCrossRef
9.
go back to reference Earlam R, Cunha-Melo JR. Benign esophageal strictures: historical and technical aspects of dilation. Br J Surg. 1981;18:829–836.CrossRef Earlam R, Cunha-Melo JR. Benign esophageal strictures: historical and technical aspects of dilation. Br J Surg. 1981;18:829–836.CrossRef
10.
go back to reference Coia LR, Myerson RJ, Tepper JE. Late effects of radiation therapy on the gastrointestinal tract. Int J Radiat Oncol Biol Phys. 1995;31:1213.PubMedCrossRef Coia LR, Myerson RJ, Tepper JE. Late effects of radiation therapy on the gastrointestinal tract. Int J Radiat Oncol Biol Phys. 1995;31:1213.PubMedCrossRef
11.
go back to reference Hishikawa Y, Kamikonya N, Tanaka S, Miura T. Esophageal stricture following high-dose-rate intracavitary irradiation for esophageal cancer. Radiology. 1986;159:715–716.PubMed Hishikawa Y, Kamikonya N, Tanaka S, Miura T. Esophageal stricture following high-dose-rate intracavitary irradiation for esophageal cancer. Radiology. 1986;159:715–716.PubMed
12.
go back to reference Teguh DN, Levendag PC, Noever I, van Rooij P, et al. Treatment techniques and site considerations regarding dysphagia-related quality of life in cancer of the oropharynx and nasopharynx. Int J Radiat Oncol Biol Phys. 2008;72:1119–1127.PubMedCrossRef Teguh DN, Levendag PC, Noever I, van Rooij P, et al. Treatment techniques and site considerations regarding dysphagia-related quality of life in cancer of the oropharynx and nasopharynx. Int J Radiat Oncol Biol Phys. 2008;72:1119–1127.PubMedCrossRef
13.
go back to reference Caudell J, Shaner P, Meredith R, Bonner J, et al. Factors associated with long-term dysphagia after definitive radiotherapy for locally advanced head-and-neck cnacer. Int J Radiat Oncol Biol Phys. 2009;73:410–415.PubMedCrossRef Caudell J, Shaner P, Meredith R, Bonner J, et al. Factors associated with long-term dysphagia after definitive radiotherapy for locally advanced head-and-neck cnacer. Int J Radiat Oncol Biol Phys. 2009;73:410–415.PubMedCrossRef
14.
go back to reference Mekhail TM, Adelstein DJ, Rybicki LA, Larto MA, et al. Enteral nutrition during the treatment of head and neck carcinoma: is a percutaneous endoscopic gastrostomy tube preferable to a nasogastric tube? Cancer. 2001;91:1785–1790.PubMedCrossRef Mekhail TM, Adelstein DJ, Rybicki LA, Larto MA, et al. Enteral nutrition during the treatment of head and neck carcinoma: is a percutaneous endoscopic gastrostomy tube preferable to a nasogastric tube? Cancer. 2001;91:1785–1790.PubMedCrossRef
15.
go back to reference Logeman JA, Rademaker AW, Pauloski BR, Lazarus CL, et al. Site of disease and treatment protocol as correlated of swallowing function in patients with head and neck cancer treated with chemoradiation. Head Neck. 2006;28:64–73.CrossRef Logeman JA, Rademaker AW, Pauloski BR, Lazarus CL, et al. Site of disease and treatment protocol as correlated of swallowing function in patients with head and neck cancer treated with chemoradiation. Head Neck. 2006;28:64–73.CrossRef
16.
go back to reference Sullivan CA, Jaklitsch MT, Haddad R, Goguen LA, et al. Endoscopic management of hypopharyngeal stenosis after organ sparing therapy for head and neck cancer. Laryngoscope. 2004;114:1924–1931.PubMedCrossRef Sullivan CA, Jaklitsch MT, Haddad R, Goguen LA, et al. Endoscopic management of hypopharyngeal stenosis after organ sparing therapy for head and neck cancer. Laryngoscope. 2004;114:1924–1931.PubMedCrossRef
Metadata
Title
Factors Affecting the Success of Endoscopic Bougia Dilatation of Radiation-Induced Esophageal Stricture
Authors
Yaşar Tuna
Erdem Koçak
Dinç Dinçer
Seyfettin Köklü
Publication date
01-02-2012
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 2/2012
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-011-1875-8

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