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- W2090636436 abstract "OBJECTIVE:To determine the efficacy of photodynamic therapy as a treatment strategy in patients with unresectable esophageal cancer and completely obstructed esophagus.METHODS:The medical records of all patients treated with photodynamic therapy for unresectalble esophageal cancer at our institution were reviewed. Five patients with newly diagnosed, completely obstructive esophageal cancer were treated. None were candidates for surgical resection because of extensive or metastatic disease. Three patients had adenocarcinoma of the distal esophagus, and 2 had squamous carcinoma of the proximal esophagus. One of the latter patients also had an esophago-cutaneous fistula arising in the esophagus proximal to the tumor and exiting in the neck. In all cases the tumor was completely obstructing the esophagus and could not be transversed utilizing endoscopic or fluoroscopic methods. All patients were treated with two sessions of photodynamic therapy commencing 48 hours after the injecion of 2 mg/Kg of Photofrin. In all cases the photodynamic therapy light probe was pushed into the tumor mass for the treatments. Within several weeks of the treatments, all 5 patients underwent a successful endoscopic placement of an expandable covered metallic esophageal stent (Ultraflex) with no difficulty in order to insure long-term patency. RESULTS:In all 5 patients treated the esophageal tumor responded to the photodynamic therapy and allowed for a safe dilatation of the previously obstructing strictures. There were no treatment related complications and no long-term serious stent related complications. The 2 patients who had proximal stents did have respiratory complications due to the extent of their disease. The esophago-cutaneous fistula healed after treatment, and then the patient tolerated external beam radiation therapy to the site. CONCLUSIONS:We have successfully applied photodynamic therapy to completely obstructive esophageal carcinoma, and then insured future patency with the placement of an expandable covered metallic stent. In all patients the esophagus remained patent after the stent placement. There were no perforations or stent migrations noted.We report this treatment strategy as a safe palliative endoscopic alternative for patients with obstructing, unresectable esophageal carcinoma who cannot be stented because of a complete obstruction. In this group placing a stent within a few weeks of photodynamic therapy appears to be safe." @default.
- W2090636436 created "2016-06-24" @default.
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- W2090636436 date "2000-04-01" @default.
- W2090636436 modified "2023-09-27" @default.
- W2090636436 title "7043 A new endoscopic strategy for the treatment of completely obstructing unresectable esophageal cancer." @default.
- W2090636436 doi "https://doi.org/10.1016/s0016-5107(00)14714-5" @default.
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