92498
document
Laser therapy combined with brachytherapy for the palliation of malignant dysphagia . BACKGROUND/AIM OF STUDY Laser therapy is effective in relieving malignant dysphagia , but repeated treatments at 4 to 6 week intervals are usually required . This prospective randomised trial is designed to determine if addition of brachytherapy offers any advantages over laser therapy alone . METHODS Patients with inoperable carcinoma of the oesophagus were randomised to receive either endoscopic Nd : YAG laser therapy alone , or laser followed by brachytherapy . Patients who developed worsening dysphagia during follow-up were offered further treatment as appropriate . RESULTS Fourteen patients were randomised to receive laser only , and 12 to receive laser followed by brachytherapy . Of these 12 , one was lost to follow-up and four did not receive brachytherapy because they were unfit , had extension into the cardia or had mainly extrinsic compression . These 4 are included on an 'intention-to-treat ' basis . The mean therapeutic interval for the brachytherapy group was significantly longer , 83 days compared to 36 days for the laser group ( p = 0.026 ) . There were no differences in the degree of dysphagia relief , number of endoscopic procedures or survival times . CONCLUSION The preliminary results of this trial suggest that brachytherapy in addition to laser therapy prolongs the first therapeutic interval . However , no long-term advantages have been shown .
92499
Intervention_Physical
Laser therapy combined with brachytherapy
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Intervention_Physical
Laser therapy
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Intervention_Physical
laser therapy
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Intervention_Physical
endoscopic Nd : YAG laser therapy
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Intervention_Physical
laser
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Intervention_Physical
brachytherapy
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Intervention_Physical
laser only
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Intervention_Physical
brachytherapy
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Intervention_Physical
brachytherapy
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Intervention_Physical
brachytherapy
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Outcome_Physical
malignant dysphagia
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Outcome_Physical
mean therapeutic interval
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Outcome_Physical
degree of dysphagia relief
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Outcome_Other
number of endoscopic procedures
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Outcome_Mortality
survival times
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Participant_Condition
Fourteen patients were randomised to receive laser only , and 12 to receive laser followed by brachytherapy .