PMID- 37268010
OWN - NLM
STAT- MEDLINE
DCOM- 20231004
LR  - 20231011
IS  - 1438-8812 (Electronic)
IS  - 0013-726X (Print)
IS  - 0013-726X (Linking)
VI  - 55
IP  - 10
DP  - 2023 Oct
TI  - A prospective multicenter study to evaluate the impact of cryotherapy on 
      dysphagia and quality of life in patients with inoperable esophageal cancer.
PG  - 889-897
LID - 10.1055/a-2105-2177 [doi]
AB  - BACKGROUND: Dysphagia palliation in inoperable esophageal cancer continues to be 
      a challenge. Self-expandable metal stents have been the mainstay of endoscopic 
      palliation but have a significant risk of adverse events (AEs). Liquid nitrogen 
      spray cryotherapy is an established modality that can be used with systemic 
      therapy. This study reports the outcomes of cryotherapy, including dysphagia and 
      quality of life (QoL), in patients receiving systemic therapy. METHODS: This was 
      a prospective multicenter cohort study of adults with inoperable esophageal 
      cancer who underwent cryotherapy. QoL and dysphagia scores before and after 
      cryotherapy were compared. RESULTS: 55 patients received 175 cryotherapy 
      procedures. After a mean of 3.2 cryotherapy sessions, mean QoL improved from 
      34.9 at baseline to 29.0 at last follow-up (P < 0.001) and mean dysphagia 
      improved from 1.9 to 1.3 (P = 0.004). Patients receiving more intensive 
      cryotherapy (>/= 2 treatments within 3 weeks) showed a significantly greater 
      improvement in dysphagia compared with those not receiving intensive therapy (1.2 
      vs. 0.2 points; P = 0.003). Overall, 13 patients (23.6 %) received another 
      intervention (1 botulinum toxin injection, 2 stent, 3 radiation, 7 dilation) for 
      dysphagia palliation. Within the 30-day post-procedure period, there were three 
      non-cryotherapy-related grade >/= 3 AEs (all deaths). The median overall survival 
      was 16.4 months. CONCLUSION: In patients with inoperable esophageal cancer 
      receiving concurrent systemic therapy, adding liquid nitrogen spray cryotherapy 
      was safe and associated with improvement in dysphagia and QoL without causing 
      reflux. More intensive treatment showed a greater improvement in dysphagia and 
      should be considered as the preferred approach.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Kachaamy, Toufic
AU  - Kachaamy T
AD  - Department of Gastroenterology, City of Hope Phoenix, Goodyear, Arizona, United 
      States.
FAU - Sharma, Neil
AU  - Sharma N
AD  - Division of Interventional Oncology and Surgical Endoscopy, Parkview Cancer 
      Institute, Fort Wayne, Indiana, United States.
FAU - Shah, Tilak
AU  - Shah T
AD  - Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland 
      Clinic, Weston, Florida, United States.
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, Arizona, 
      United States.
FAU - Mohapatra, Sonmoon
AU  - Mohapatra S
AD  - Department of Gastroenterology and Nutrition, City of Hope Chicago, Zion, 
      Illinois, United States.
FAU - Pollard, Kimberly
AU  - Pollard K
AD  - Division of Gastroenterology and Hepatology, Central Virginia VA Healthcare 
      System, Richmond, Virginia, United States.
FAU - Zelt, Christina
AU  - Zelt C
AD  - Division of Interventional Oncology and Surgical Endoscopy, Parkview Cancer 
      Institute, Fort Wayne, Indiana, United States.
FAU - Jewett, Elaine
AU  - Jewett E
AD  - Department of Gastroenterology, City of Hope Phoenix, Goodyear, Arizona, United 
      States.
FAU - Garcia, Rigoberto
AU  - Garcia R
AD  - Department of Gastroenterology, City of Hope Phoenix, Goodyear, Arizona, United 
      States.
FAU - Munsey, Rachel
AU  - Munsey R
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, Arizona, 
      United States.
FAU - Gupta, Saurabh
AU  - Gupta S
AD  - Division of Interventional Oncology and Surgical Endoscopy, Parkview Cancer 
      Institute, Fort Wayne, Indiana, United States.
FAU - Rojas-DeLeon, Mariajose
AU  - Rojas-DeLeon M
AD  - Division of Interventional Oncology and Surgical Endoscopy, Parkview Cancer 
      Institute, Fort Wayne, Indiana, United States.
FAU - Gupta, Digant
AU  - Gupta D
AD  - Division of Gastroenterology and Hepatology, Central Virginia VA Healthcare 
      System, Richmond, Virginia, United States.
FAU - Kaul, Vivek
AU  - Kaul V
AD  - Division of Gastroenterology and Hepatology, University of Rochester Medical 
      Center, Rochester, New York, United States.
FAU - Pannala, Rahul
AU  - Pannala R
AD  - Department of Gastroenterology and Nutrition, City of Hope Chicago, Zion, 
      Illinois, United States.
FAU - Vashi, Pankaj
AU  - Vashi P
AD  - Division of Gastroenterology and Hepatology, Central Virginia VA Healthcare 
      System, Richmond, Virginia, United States.
LA  - eng
SI  - ClinicalTrials.gov/NCT03285035
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
DEP - 20230602
PL  - Germany
TA  - Endoscopy
JT  - Endoscopy
JID - 0215166
RN  - N762921K75 (Nitrogen)
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Deglutition Disorders/etiology/therapy
MH  - Quality of Life
MH  - Cohort Studies
MH  - Prospective Studies
MH  - *Esophageal Neoplasms/complications/therapy
MH  - Cryotherapy/adverse effects
MH  - Stents/adverse effects
MH  - Nitrogen
MH  - Palliative Care/methods
PMC - PMC10533213
COIS- T. Kachaamy is a consultant for Steris, Pentax, Microtech, Medtronics, and Boston 
      Scientific; he also serves on an advisory board for Steris, has a product 
      licensing agreement with Microtech, and has intellectual property partnership 
      with an international private bank. N. Sharma is a consultant for Steris, Boston 
      Scientific, Medtronic, and Olympus. T. Shah is a consultant for Steris. M. 
      Rojas-DeLeon is a consultant for Boston Scientific. V. Kaul is a consultant for 
      Steris, CDX Diagnostics, Ambu, Cook Medical, and Motus GI. R. Pannala is a 
      consultant for HCL Technologies, advisory board member for Nestle and Bluestar 
      Genomics, and has received research support from ERBE USA and Fractyl 
      Labs. S. Mohapatra, K. Pollard, C. Zelt, E. Jewett, R. Garcia, R. Munsey, 
      S. Gupta, D. Gupta, and P. Vashi declare that they have no conflict of interest.
EDAT- 2023/06/03 11:42
MHDA- 2023/10/04 06:43
PMCR- 2023/07/01
CRDT- 2023/06/02 19:13
PHST- 2023/10/04 06:43 [medline]
PHST- 2023/06/03 11:42 [pubmed]
PHST- 2023/06/02 19:13 [entrez]
PHST- 2023/07/01 00:00 [pmc-release]
AID - 10.1055/a-2105-2177 [doi]
PST - ppublish
SO  - Endoscopy. 2023 Oct;55(10):889-897. doi: 10.1055/a-2105-2177. Epub 2023 Jun 2.