Use of ethanol-induced tumor necrosis to palliate dysphagia in patients with esophagogastric cancer.

Eleven patients with dysphagia caused by inoperable, unresectable, or recurrent esophagogastric cancer were treated by endoscopic injection of ethanol (with or without per-oral dilation) to induce tumor necrosis. Prior to treatment, patients had a mean dysphagia grade of 3. After one treatment, dysphagia grade had improved to a mean of 1.5. An optimum dysphagia grade (mean, 0.9) was achieved after a mean of 1.6 injection treatments. Treatments were repeated as symptoms recurred, with a mean period between repeat treatments of 32 days (median, 26). There were no complications associated with ethanol-induced tumor necrosis (ETN). Mean patient survival was 140 days (median, 109). These results suggest that ETN has considerable potential for palliation of malignant dysphagia in selected patients.