Radiotherapy enhances laser palliation of malignant dysphagia: a randomised study

Area of Science:

• Oncology
• Gastroenterology
• Palliative Care

Background:

• Malignant dysphagia often requires repeated laser endoscopy for palliation.
• The need for frequent endoscopic treatments presents a significant drawback.

Purpose of the Study:

• To evaluate if external beam radiotherapy can decrease the requirement for repeated laser therapy in malignant dysphagia.
• To assess the impact of radiotherapy on the frequency of endoscopic interventions.

Main Methods:

• A randomized controlled trial involving 67 patients with inoperable esophageal or gastric cardia cancers.
• Patients received either palliative external beam radiotherapy (30 Gy in 10 fractions) or no radiotherapy after initial laser recanalization.
• Endoscopic follow-up was performed at 5 weeks and as needed for recurrent dysphagia.

Main Results:

• Dysphagia relief was comparable between the radiotherapy and control groups.
• The median interval for dysphagia control and treatment increased from 5 to 9 weeks in the radiotherapy group (p < 0.01).
• Radiotherapy was generally well-tolerated, with rare complications like perforation and fistula formation.

Conclusions:

• External beam radiotherapy effectively reduces the need for repeat therapeutic endoscopy in palliative cancer care.
• Radiotherapy is beneficial for patients with a sufficient prognosis to experience long-term advantages.