Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Oral complications from cancer chemotherapy are well documented for the hematologic malignancies but are less well defined for cancers of the head and neck. This prospective study examined 82 patients with stage III or IV disease to determine the incidence and severity of oral sequelae following a total of 141 cycles of neoadjuvant chemotherapy. Taste alteration (37%) was the most frequent problem, followed by mucositis (30%) and ulceration (22%). Xerostomia, increased salivary flow, loss of appetite, weight loss, dysphagia, bleeding, and infection were also encountered. We conclude that oral problems are common following chemotherapy for head and neck tumors and that more aggressive investigational protocols will result in a much higher incidence and severity of problems. Prevention of these sequelae by conventional as well as investigational means is important to keep them from becoming dose-limiting problems.
 ...
PMID:Oral complications following neoadjuvant chemotherapy in patients with head and neck cancer. 234 98

Thirty-five patients with nonmetastatic squamous cell carcinoma of the esophagus were treated with chemotherapy (5-fluorouracil, cisplatin) and concomitant split-course radiation therapy. All of the patients presented with dysphagia. Treatment consisted of two courses of chemotherapy with 5-FU (1 g/m2/day in continuous infusion for 5 days [days 1 to 5 and days 29 to 33] ) and cisplatin (70 mg/m2 intravenous bolus at days 2 and 30). Radiation therapy was concomitant in two courses delivering 20 Gy in 5 days (days 1 to 5 and days 29 to 33). On the first day of treatment, endoscopic peroral dilation or Nd-YAG laser therapy was usually carried out. At the end of the treatment, all of the patients were capable of oral nutrition. Histoendoscopic confirmation was made 8 weeks after the beginning of the therapy. Twenty-five of the 35 patients had a complete response with negative biopsy findings. There was only one serious complication (fatal myelosuppression) in the only patient who received more than two courses of chemotherapy. Sixteen patients died and 19 were still alive at 3 to 42 months after the beginning of treatment. Overall median survival for the 35 patients is 17 months. Actuarial survival was 55 +/- 18% at 1 year and 41 +/- 21% at 2 years. The median survival of the Stage I and II patients is 28 months. These results confirm that concomitant chemoradiotherapy is capable of producing a very high histoendoscopic complete response rate and improved 1-year and 2-year survival. The use of concentrated split-course radiotherapy enabled the authors to reduce the total length of the treatment to two periods of 5 days, with results that are similar to previous studies using classic radiotherapy for a 5-week to 7-week period.
Cancer 1990 Jul 15
PMID:Inoperable nonmetastatic squamous cell carcinoma of the esophagus managed by concomitant chemotherapy (5-fluorouracil and cisplatin) and radiation therapy. 236 7

The paper discusses the results of treatment of 152 cases of cancer of the esophagus and proximal part of the stomach presenting with grade III-IV dysphagia. In 107 patients, treatment included endoscopic laser coagulation of tumor: in 52 the procedure was combined with radiation and in 18 cases-with chemotherapy, whereas in 37 patients the method was used alone for palliation only attempting at return to enteral nutrition. Histories of 45 patients with esophageal cancer who had received standard treatment served as control. Laser coagulation-associated lethality was 1.9%. Normal food passage was restored in 97.6% of esophageal cancer patients and in 96% of those with cancer of the proximal part of the stomach. The mean overall survival was 8.7, 8.4 and 7.3 months for the study groups and 3.2 months only for controls. The mean dysphagia-free survival was 48.5 days.
 ...
PMID:[Endoscopic laser coagulation of the tumor in patients with cancer of the esophagus and proximal portion of the stomach]. 237 82

A series of 188 patients with cancer of the esophagogastric junction were operated from 1960 to 1985. Their age range was 18-79 years old and 73% were males. Mean duration of symptomatology was five months and 93% were affected by dysphagia. Surgery was limited to exploratory laparotomy in 17 patients (9%), feeding gastrostomy in 14 (7.5%), Celestin endoluminal tube in 31 (16.5%), jejunal by-pass in one and tumoral resection in 125 (66.5%). The predominant procedures of resection were total (64%) and proximal gastrectomy (28%). To restore digestive continuity, the stomach was used in 40 (32%) cases, jejunum in 67 (53.6%) and colon in 18 (14.4%). Eighty-eight per cent of tumors were adenocarcinomas. Seventeen per cent of patients died in the post-operative period: 18.4% following resection (17.5% following partial gastrectomy and 18.8% following total gastrectomy) and 14% following palliative measures. Five-year survival rates were 11.8% for resected cases, 8.7% for total gastrectomized patients and 18.2% for partial gastrectomized tumors.
 ...
PMID:Surgical management of malignant tumors of the esophagogastric junction: a retrospective review of 188 patients. 237 96

Dysphagia is common in patients with cancer of the esophagus or cardia. The rate of resectability of the lesion is low, and the majority of patients require palliation to relieve the dysphagia. Esophageal intubation is a simple, safe method at present. However, migration of the tube is a frequently reported complication. To prevent dislodgment of the tube, an esophageal tube with spiral grooves and a distal ring has been devised and used in 334 patients in the Veterans General Hospital, Taipei, Taiwan. There have been no operative deaths. The postoperative complication rate was 15%; migration of the tube comprised only 2.7% of that figure.
 ...
PMID:A spiral-grooved endoesophageal tube for management of malignant esophageal obstruction. 240 91

Esophageal dilation by means of guided Neoplex (Medoc) tubes in 38 patients with malignant obstruction of the esophagus was analyzed. Peroral dilation proved to be a simple, well-tolerated primary procedure in the management of malignant strictures. Most patients have a temporary improvement of dysphagic symptoms, but the benefit appears to decrease progressively in successive dilatatory sessions. Dilations were more difficult, with a 10% perforation rate, in previously radiated patients. Esophageal dilations may play a complementary role in addition to other palliative techniques in the management of malignant dysphagia.
Cancer 1985 Dec 01
PMID:Esophageal dilation in malignant dysphagia. 241 80

Esophageal prothesis (EP) is a palliative treatment for inoperable neoplastic stenosis. Ninety-one patients were candidates for EP placement between 1978 and 1983. EP placement was successful in 77 patients. Of these: 85% had primary esophageal cancer; 15% had bronchial or mediastinal carcinoma; 83% had stenosis in the middle third. Dysphagia was the main symptom in 84%, and tracheoesophageal fistulae in 16%. The observed median survival was 3.2 months +/- 1.9 (2 standard deviations [SD]), and the survival rate at 1 year was 7%. With the single-factor analysis method, not one of 12 factors presented any significance (age, sex, general status, anterior treatment, lesion site, endoscopic feature, stenosis diameter, histologic features, metastasis, tracheal involvement, symptoms, and type of prothesis). Two factors had a P value approaching significance: there were slightly longer survival rates in patients with a stenosis diameter less than 7 mm (P less than 0.07), and with stenosis located in the lower third and cardia (P less than 0.07). By multivariate analysis (Cox model), prognostic significance was found in only one factor: the location in the lower third and cardia (P = 0.002, relative risk = 3). The quality of life after EP placement was briefly improved: 80% of 73 evaluable patients had improvement in dysphagia for a mean duration of 3.7 months +/- 2 (2 SD), especially patients with a good general status (0 and 1; P less than 0.01); and 45% of patients had improvement of their general status for a mean duration of 4.1 months +/- 2 (2 SD). Minor complications related to EP placement were observed in 40% of patients (pain, obstruction, and mobilization), and severe complications were observed in 20% (perforation, 11 cases; fistulae, 5 cases, with death in 3 cases; hemorrhages, 4 cases). In conclusion, EP is a good palliative treatment, although complications are frequent, and evaluation of patient comfort is required to compare this procedure with other available techniques.
Cancer 1986 Apr 01
PMID:Esophageal prothesis for neoplastic stenosis. A prognostic study of 77 cases. 241 40

The endoscopic insertion of an endoprosthesis is now a standard procedure in the ultimate palliation of malignant obstructing upper gastrointestinal and biliary malignancy. The commercially available prostheses and introducing devices are adequate for the majority of upper intestinal cancers. For some stricturing lesions, especially when associated with fistula formation, individual adaptation of a tygon prosthesis with extra widening rings is often necessary. Nd: Yag laser vaporisation of mainly exophytic cancerous tissue is mainly indicated for those circumstances which are less amenable to prosthesis insertion such as total luminal obstruction, noncircumferential tumorous involvement, polypoid cancers, excessively necrotic and chronically bleeding tumors, lesions extending within 2 cm of the upper esophageal sphincter, markedly angulated cancers of the cardia with almost horizontal tube positioning and cancerous overgrowth occluding the funnel opening. Overall successful insertion occurs in over 90% of patients. Main complications are perforation 5-8% and early or late dislocation. The procedure related mortality fluctuates around 2 to 4%. Overall results with laser application are roughly comparable. The dysphagia free intervall after laser is only around 6 weeks for the majority of the patients. Transpapillary insertion of a straight Amsterdam-type prosthesis rapidly became a standard procedure for palliation of malignant jaundice. For many patients with pancreatic cancer this endoscopic approach competes favorably with corresponding surgical palliative alternatives. Disappearance of jaundice is to be expected in the vast majority of the patients. The only major unsolved problem remains late clogging with biliary sludge which necessitates insertion of new prostheses. Most problematic to breach are bifurcation tumors. Cholangitis is a major complication if one does not succeed at the first attempt to drain both liver lobes.
 ...
PMID:Upper intestinal and biliary tract endoprosthesis. 242 67

Dysphagia, regurgitation and hypersalivation due to local destruction or incessant coughing in the presence of a tracheo-broncho-esophageal fistula become the most important distressing factors in the end stage of malignancies in the upper gastrointestinal tract. Inevitably such patients have a short life expectancy. It is often desirable to avoid the morbidity associated with surgery, radiotherapy or chemotherapy. The non-operative insertion of a prosthesis is increasingly being carried out to palliate malignant dysphagia.
 ...
PMID:Endoscopic prosthesis for advanced esophageal cancer. 242 9

One-hundred patients treated with oesophageal intubation for stricture-forming inoperable oesophago-gastric malignancies during the years 1972 to 1983 were analyzed. Fifteen tubes were endoscopically positioned, the rest by thoracotomy or laparotomy. Seven patients died from causes related to the intubation, the causes of death being perforation (2), mediastinitis (3) or aortic erosion (2). Mean survival-time was three months (range one day to 14 months). Nineteen of the most deteriorated patients died within two weeks. Eighty-seven percent of the patients experienced relief of dysphagia. Thus the intended palliation was satisfactory and the results therefore support oesophageal intubation as an alternative to be considered in the treatment of malignancies of the oesophagus and cardia. However, deteriorated patients with extremely short life expectancy might not benefit from the procedure.
 ...
PMID:Palliative intubation in malignant stricture of the oesophagus and cardia. 243 39


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>