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Radiology. 1997 Feb;202(2):344-8.

Palliation of inoperable esophageal carcinoma: a prospective randomized trial of laser therapy and stent placement.

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1
Department of Radiology, United Medical School of Guy's Hospital, London, England.

Abstract

PURPOSE:

A prospective, randomized comparison of the result of endoscopic laser therapy and that of placement of self-expandable metallic endoprostheses was performed to determine which method provides the best palliation of dysphagia in patients with inoperable esophageal carcinoma.

MATERIALS AND METHODS:

Sixty patients participated in the study. Twenty-three were randomly assigned to undergo plastic-covered stent placement, 19 to undergo uncovered stent placement, and 18 to undergo laser therapy. The quality of swallowing was assessed with the dysphagia score, which ranged from 0 for normal swallowing to 4 for complete dysphagia.

RESULTS:

The mean improvement in dysphagia score was 2 and ranged from -1 to 3 in patients who underwent placement of plastic-covered stents, was 2 and ranged from 0 to 4 in those who underwent placement of uncovered stents, and was 1 and ranged from 0 to 2 in those who underwent laser therapy. Six of 23 (26%) plastic-covered stents migrated, whereas none of the uncovered stents did so (P < .02). Tumor ingrowth through uncovered stents occurred in five of 19 patients (26%).

CONCLUSION:

Placement of metallic esophageal endoprostheses is substantially better than endoscopic laser therapy for palliation of dysphagia in patients with inoperable esophageal carcinoma. Use of uncovered and plastic-covered metallic stents provides equal palliation in patients with dysphagia.

[Indexed for MEDLINE]

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