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

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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.

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References

  1. 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.

    Article  PubMed  CAS  Google Scholar 

  2. 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.

    Article  PubMed  Google Scholar 

  3. Laurell G, Kraepelien T, Mavroidis P. Stricture of the proximal esophagus in head and neck carcinoma patients after radiotherapy. Cancer. 2003;97:1693–1700.

    Article  PubMed  Google Scholar 

  4. 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.

    Article  PubMed  Google Scholar 

  5. Ahlawat S, Al-Kawas F. Endoscopic management of upper esophageal strictures after treatment of head and neck malignancy. Gastrointest Endosc. 2008;68:19–24.

    Article  PubMed  Google Scholar 

  6. 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.

    Article  PubMed  CAS  Google Scholar 

  7. 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.

    Article  PubMed  CAS  Google Scholar 

  8. 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.

    Article  PubMed  Google Scholar 

  9. Earlam R, Cunha-Melo JR. Benign esophageal strictures: historical and technical aspects of dilation. Br J Surg. 1981;18:829–836.

    Article  Google Scholar 

  10. Coia LR, Myerson RJ, Tepper JE. Late effects of radiation therapy on the gastrointestinal tract. Int J Radiat Oncol Biol Phys. 1995;31:1213.

    Article  PubMed  CAS  Google Scholar 

  11. 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  CAS  Google Scholar 

  12. 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.

    Article  PubMed  Google Scholar 

  13. 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.

    Article  PubMed  Google Scholar 

  14. 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.

    Article  PubMed  CAS  Google Scholar 

  15. 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.

    Article  Google Scholar 

  16. 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.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Gastroenterology, Akdeniz University Medical School of Medicine, Antalya, Turkey

    Yaşar Tuna & Dinç Dinçer

  2. Department of Gastroenterology, Ankara Education and Research Hospital, Keklikpınarı mahallesi, 240 sokak, Duru apartmanı, 8/6, Dikmen, Çankaya, Ankara, Turkey

    Erdem Koçak & Seyfettin Köklü

Authors
  1. Yaşar Tuna
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  2. Erdem Koçak
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  3. Dinç Dinçer
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  4. Seyfettin Köklü
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Correspondence to Erdem Koçak.

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Tuna, Y., Koçak, E., Dinçer, D. et al. Factors Affecting the Success of Endoscopic Bougia Dilatation of Radiation-Induced Esophageal Stricture. Dig Dis Sci 57, 424–428 (2012). https://doi.org/10.1007/s10620-011-1875-8

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  • DOI: https://doi.org/10.1007/s10620-011-1875-8

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