J Korean Radiol Soc.  2001 Aug;45(2):155-159. 10.3348/jkrs.2001.45.2.155.

Malignant Strictures Involving the Esophagogastric Junction: Palliative Treatment with Balloon Dilation Combined with Chemotherapy and/or Radiotherapy

• Hong HJ
• Ko GY
• Song HY
• Cho YS
• Sung KB

• KMID: 1583393
• DOI: http://doi.org/10.3348/jkrs.2001.45.2.155

Abstract

PURPOSE: To overcome the limitations of expandable metallic stent placement by using balloon dilation combined with chemotherapy or radiation therapy in the treatment of malignant esophageal strictures involving the esophagogastric junction (EGJ).
MATERIALS AND METHODS
Fluoroscopically guided balloon dilation was performed in 14 patients with strictures due to squamous cell carcinoma (n=5) or adenocarcinoma (n=9). After balloon dilation all patients underwent chemotherapy or radiation therapy.
RESULTS
There were no technical failures or major complications. After dilation, dysphagia improved in 13 (92%) of 14 patients, and the long-term success rate was 50%. Six of the seven patients in whom the condition recurred underwent further balloon dilation (n=4) or placement of an expandable metallic stent (n=2). Ten of the 13 who were followed up died after diffuse metastasis. Prior to their eventual death (mean survial, 20 weeks), the dysphagia experienced by seven (70%) of these ten improved, and thus they required no further treatment.
CONCLUSION
Balloon dilation combined with chemotherapy or radiation therapy seems to be a safe and effective secondary therapy for patients with dysphagia due to malignant stiricture involving the EGJ.

Keyword

Esophagus, neoplasms; Esophagus, interventional procedures; Esophagus, stenosis or obstruction

MeSH Terms

Adenocarcinoma
Carcinoma, Squamous Cell
Constriction, Pathologic*
Deglutition Disorders
Drug Therapy*
Esophagogastric Junction*
Humans
Neoplasm Metastasis
Palliative Care*
Radiotherapy*
Stents