Department of Gastroenterology, Akdeniz University Medical School of Medicine, Antalya, Turkey.
Dig Dis Sci. 2012 Feb;57(2):424-8. doi: 10.1007/s10620-011-1875-8. Epub 2011 Aug 31.
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.
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.
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.
Endoscopic bougie dilation is a safe and effective procedure for the management of radiation-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.
本回顾性研究旨在评估头颈部癌症放射治疗后内镜球囊扩张治疗食管狭窄的临床效果,并评估影响治疗成功的相关因素。
31 例因放射治疗导致食管狭窄的患者接受了内镜球囊扩张治疗。评估了以下参数:年龄、性别、肿瘤原发部位、肿瘤初始治疗、放射治疗的处方剂量、放射治疗后食管狭窄的发病时间、根据临床和内镜发现的食管狭窄程度分级、扩张次数、食管狭窄的复发情况以及治疗效果。
平均随访时间为 26 个月,范围为 1-84 个月。31 例患者中,26 例患者的内镜球囊扩张治疗成功。对内镜球囊扩张治疗无反应的患者,放射治疗后食管狭窄的发病时间明显更短。
内镜球囊扩张是治疗放射性食管狭窄的一种安全有效的方法。食管狭窄发病时间是治疗成功的最重要因素。此外,放射治疗的总处方剂量对内镜球囊扩张的效果影响最小。