Endoscopic Injection of Mitomycin C for the Treatment of Pharyngoesophageal Stenosis Refractory to Endoscopic Treatment with Dilatation in Patients Treated for Head and Neck Cancer.

Autor: Gusmon-Oliveira CC; Department of Gastroenterology, Endoscopy Unit of the Cancer Institute of São Paulo-ICESP, Brazil., Kuboki YM; Department of Gastroenterology, Endoscopy Unit of the Cancer Institute of São Paulo-ICESP, Brazil., de Paulo GA; Department of Gastroenterology, Endoscopy Unit of the Cancer Institute of São Paulo-ICESP, Brazil., de Lima MS; Department of Gastroenterology, Endoscopy Unit of the Cancer Institute of São Paulo-ICESP, Brazil., Uemura RS; Department of Gastroenterology, Endoscopy Unit of the Cancer Institute of São Paulo-ICESP, Brazil., Martins BC; Department of Gastroenterology, Endoscopy Unit of the Cancer Institute of São Paulo-ICESP, Brazil., Tolentino LL; Department of Gastroenterology, Endoscopy Unit of the Cancer Institute of São Paulo-ICESP, Brazil., Safatle-Ribeiro AV; Department of Gastroenterology, Endoscopy Unit of the Cancer Institute of São Paulo-ICESP, Brazil., Kulcsar MA; Department of Gastroenterology, Endoscopy Unit of the Cancer Institute of São Paulo-ICESP, Brazil., Ribeiro U Jr; Department of Gastroenterology, Endoscopy Unit of the Cancer Institute of São Paulo-ICESP, Brazil., Maluf-Filho F; Department of Gastroenterology, Endoscopy Unit of the Cancer Institute of São Paulo-ICESP, Brazil.
Jazyk: angličtina
Zdroj: Gastroenterology research and practice [Gastroenterol Res Pract] 2018 Nov 12; Vol. 2018, pp. 5428157. Date of Electronic Publication: 2018 Nov 12 (Print Publication: 2018).
DOI: 10.1155/2018/5428157
Abstrakt: Background: Management of pharyngoesophageal stenosis (PES) in patients after head and neck cancer (HNC) treatment remains a challenge. It is not uncommon that PES is refractory to dilation sessions. This study aimed at evaluating the efficacy of Mitomycin C (MMC) endoscopic injection for the treatment of refractory pharyngoesophageal stenosis.
Patients and Methods: This is a prospective study in patients with dysphagia following head and neck cancer treatment, without evidence suggestive of tumor recurrence, and refractory to endoscopic treatment. These patients were submitted to endoscopic dilation of the stenotic segment with thermoplastic bougies, followed by injection of MMC. We repeated the endoscopic sessions every three weeks.
Results: From January 2015 to May 2015, we treated 13 patients with PES. Three patients were initially enrolled in the study for refractory stricture. We observed adverse events in all of them, with intense neck pain and ulcer development, justifying the interruption of the trial.
Conclusion: The repeated injection in the short interval of MMC in refractory PES is not recommended, because it resulted in serious adverse events.
Databáze: MEDLINE
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