Abstract
Background The contribution of dysmotility to dysphagia in oesophageal cancer is unclear.
Aim To examine oesophageal motility in patients with oesophageal carcinoma and to assess the effect of chemoradiotherapy on motility.
Methods Stationary manometry and 24-hour pH-metry were performed in 12 patients with oesophageal carcinoma and one week following completion of chemoradiotherapy using 5-fluorouracil (5-FU), cisplatin and 40Gy radiotherapy.
Results All patients had abnormal motility prior to treatment. Peristalsis was impaired in 11 patients with a mean (SD) of 25% (9) of waves normally propagated. Eight patients had 20% or more simultaneous waves. Following chemoradiotherapy, the percentage of waves normally propagated increased from 25% (9) to 52% (10) (p < 0.03) and normal peristalsis was restored in four patients. The percentage of simultaneous waves decreased from 38% (11) to 21.6% (10) (p=0.129) while the percentage of dropped or increased waves decreased from 20% (11) to 8.3% (4) (p=0.264).
Conclusions Oesophageal motility is disturbed in oesophageal cancer. Dysphagia in oesophageal cancer may be partly explained by oesophageal dysmotility. This is improved by chemotherapy.
Similar content being viewed by others
References
Benasco C, Combalia N, Pou JM. Superficial oesophageal carcinoma: a report of 12 cases.Gastrointest Endoscopy 1985; 31: 64–7.
Leichman L, Steiger Z, Seydel HG et al. Preoperative chemotherapy and radiation therapy for patients with cancer of the oesophagus: a potentially curative approach.J Clin Oncol 1984; 2: 75–9.
Walsh TN, Noonan N, Keeling PWN et al. Chemotherapy, radiotherapy and surgery versus surgery alone for oesophageal squamous cell carcinoma.Br J Surg 1993; 80: S61.
Muller JM, Erasmi H, Stelzner M et al. Surgical therapy of oesophageal carcinoma.Br J Surg 1990; 77: 845–57.
Walsh TN, Noonan N, Hollywood D et al. A comparison of multimodal therapy and surgery for oesophageal adenocarcinoma.NEJM 1996; 335(7): 462–7.
Jazrawi S, Walsh TN, Byrne PJ et al. Cholecystectomy and oesophageal reflux: a prospective evaluation.Br J Surg 1993; 80: 50–3.
Rothwell JF, Lawlor P, Byrne PJ et al. Cholecystectomy-induced gastroesophageal reflux: is it reduced by the laparoscopic approach?Am J Gastroenterol 1997; 92(8): 1351–4.
DeMeester TR, Skinner DB. Esophageal disorders: Pathophysiology and therapy. New York, NY: Raven Press, 1985.
Duranceau AC, Devrode G, Lafontaine E et al. Esophageal motility in asymptomatic human volunteers.Surg Clin N Am. 1983; 63: 777–86.
Nagler R, Spiro AM. Serial esophageal motility studies in asymptomatic young subjects.Gastroenterology 1961; 41: 371–9.
Richter JE, Wu WC, Jophns DN et al. Esophageal manometry in 95 healthy adult volunteers: variables of pressure with age and frequency of abnormal contractions.Dig Dis Sci 1977; 22: 641–5.
Humphries TJ, Castell DO. Pressure profile of oesopheageal peristalsis in normal humans as measures by direct intraoesopheageal transducers.Dig Dis Sci 1977; 22: 641–5.
O’Hanrahan T, Bancewicz J, Thompson D et al. Esophageal reflux responses: abnormalities of the enteric nervous system in patients with oesophageal symptoms.Br J Surg 1992; 79: 938–41.
Frieling T, Enck P. What are the modifications of oesophageal motility produced by balloon distension? In Giuli R, McCallum RW and Skinner DB, Primary Motility Disorders of the Oesophagus, eds. John Libbey Eurotext, Paris Londres Romes 1991: 29–32.
Mann CV, Code CF, Schegel JF et al. Intrinsic mechanisms controlling the mammalian gastroesophageal sphincter deprived of extrinsic nerve supply.Thorax 1968; 23: 634–9.
Kendall GPN, Thompson DG, Day SJ et al. Motor responses of the esophagus to intraluminal distension in normal subjects and in patients with esophageal clearance disorders.Gut 1987; 28: 272–9.
Stein HJ, Hoeft S, DeMeester TR. Functional foregut abnormalities in Barrett’s oesophagus.J Thoracic Cardiovasc Surg 1993; 105(1): 107–11.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tormey, S., Nasyr, A., McNamara, D. et al. Effect of tumour and chemoradiotherapy on oesophageal motility. Ir J Med Sci 172, 9–12 (2003). https://doi.org/10.1007/BF02914777
Issue Date:
DOI: https://doi.org/10.1007/BF02914777