Role of mitomycin in upper digestive tract stricture

Area of Science:

• Oncology
• Gastroenterology
• Otolaryngology

Background:

• Mitomycin C is an anti-fibroblast agent with potential for treating head and neck cancer complications.
• Upper digestive tract strictures are a common sequela of head and neck cancer treatment.
• Cervical stenosis is a known complication that Mitomycin C has shown promise in treating.

Purpose of the Study:

• To evaluate the safety and efficacy of Mitomycin C in treating upper digestive tract strictures.
• To assess the impact of Mitomycin C on swallowing function and quality of life.
• To investigate Mitomycin C as an adjunct to dilation therapy for benign strictures.

Main Methods:

• A study involving twelve patients with progressive dysphagia and upper digestive tract stricture.
• Dilation using Maloney or Savory dilators followed by topical Mitomycin C application (0.2 mg/0.4 mL saline) for 5 minutes.
• Outcome measures included complication rates, dietary consistency, and quality of life using the M. D. Anderson Dysphagia Inventory.

Main Results:

• All patients showed significant improvement in dietary consistency (p = .002).
• Swallowing-related quality of life scores also improved significantly (p = .001).
• No complications were reported from the use of Mitomycin C during the mean 19-month follow-up.

Conclusions:

• Topical Mitomycin C application appears safe and effective for head and neck cancer-related upper digestive tract strictures.
• Further research, including randomized controlled trials, is necessary to confirm these findings.
• Mitomycin C may offer additional benefits when used with standard dilation therapy.