Palliative Treatment of the Upper Gastrointestinal Tract Using a Combination of Laser Therapy and Intracavitary Radiation

Palliative treatment of malignant stenoses of the upper gastrointestinal tract should be instituted only when, on the basis of previous staging and assessment of the risk involved, curative surgery is no longer possible. Resection of an esophageal carcinoma is contraindicated by infiltration of the growth into the trachea or other organs, as revealed by CT or magnetic resonance. Invasion of the bronchial system by the tumor can be detected with the aid of bronchoscopy. Distant metastasis, poor pulmonary function, and cirrhosis of the liver also militate against resection [13]. For this reason endoscopic implantation of an endoproth-esis should not be carried out without discussing the oncological situation with the surgeon. Since the implantation of a tube does not always satisfactorily improve the quality of the patient’s life [1, 3], in the past 18 months, as an alternative to endoscopic tube implantation, we have submitted 93 patients to intracavitary afterloading following prior laser therapy [2].