Palliative care 2017

Dysphagia in esophageal cancer - treatment

• Dysphagia mostly in esophageal cancer, but also in head and

neck cancer

• Risk of cachexia, dehydratation, aspiration pneumonia

• Procedures used:

– endoscopic dilatation,

– stenting,

– PhotoDynamicTherapy,

– APC laser and

– Radiotherapy

• CONSORT1a,b: best results in recanalisation, days to recurrence

dysphagia and QoL for

combination of APC and HDR

(88 days vs

35 days, p=0.002)

(Rupinski M, Am J Gastroenter 2011)

• Respons after RT lasts longer than stenting due to

decrease of

tumor volume.

• Single fraction BT bettter than stenting alone in long term relief,

toxicity and QoL

(Homs M. Lancet 2004 SIREC)

JK 32/49