| Autor: |
Homs, M. Y. V., Steyerberg, E. W., Eijkenboom, W. M. H., Tilanus, H. W., Stalpers, L. J. A., Bartelsman, J. F. W. M., van Lanschot, J. J. B., Wijrdeman, H. K., Mulder, C. J. J., Reinders, J. G., Boot, H., Aleman, B. M. P., Kuipers, E. J., Siersema, P. D. |
| Přispěvatelé: |
CCA -Cancer Center Amsterdam, Radiotherapy, Gastroenterology and Hepatology, Surgery |
| Jazyk: |
Dutch; Flemish |
| Rok vydání: |
2005 |
| Předmět: |
|
| Zdroj: |
Nederlands tijdschrift voor geneeskunde, 149(50), 2800-2806. Bohn Stafleu van Loghum |
| ISSN: |
0028-2162 |
| Popis: |
OBJECTIVE: To compare the results of single-dose internal irradiation (brachytherapy) and self-expanding metal stent placement in the palliation of oesophageal obstruction due to cancer of the oesophagus. DESIGN: Randomised trial. METHOD: In the period from December 1999-Jun 2002, 209 patients with dysphagia due to inoperable carcinoma of the oesophagus were randomised to placement of an Ultraflex stent (n = 108) or single-dose (12 Gy) brachytherapy (n = 101). Primary outcome was relief of dysphagia; secondary outcomes were complications, persistent or recurrent dysphagia, health-related quality of life, and costs. Patients were followed up by monthly home visits from a specialised nurse. RESULTS: Dysphagia improved more rapidly after stent placement than after brachytherapy, but long-term relief of dysphagia was better after brachytherapy. Stent placement resulted in more complications than did brachytherapy (36/108 (33%) versus 21/101 (21%); p = 0.02), due mainly to an increased incidence of late haemorrhage in the stent group (14 versus 5; p = 0.05). The groups did not differ with regard to the incidence of persistent or recurrent dysphagia or median survival (p > 0.20). In the long term, quality-of-life scores were higher in the brachytherapy group. Total medical costs were also similar for both treatments: Euro 8,215 for stent placement and Euro 8,135 for brachytherapy. CONCLUSION: Brachytherapy provided better long-term relief of dysphagia than did stent placement and also produced fewer complications. Brachytherapy is therefore recommended as the preferred treatment for the palliation of dysphagia due to oesophageal cancer |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
