Endoscopic Injection of Mitomycin C for the Treatment of Pharyngoesophageal Stenosis Refractory to Endoscopic Treatment with Dilatation in Patients Treated for Head and Neck Cancer

Overview

Journal Gastroenterol Res Pract

Publisher Wiley

Specialty Gastroenterology

Date 2018 Dec 13

PMID 30538738

Citations 2

Authors

Carla Cristina Gusmon-Oliveira

Yeda Mayumi Kuboki

Gustavo Andrade de Paulo

Marcelo Simas de Lima

Ricardo Sato Uemura

Bruno Costa Martins

Luciano Lenz Tolentino

Adriana Vaz Safatle-Ribeiro

Marco Aurelio Kulcsar

Ulysses Ribeiro Jr

Fauze Maluf-Filho

Affiliations

Soon will be listed here.

Abstract

Background: Management of pharyngoesophageal stenosis (PES) in patients after head and neck cancer (HNC) treatment remains a challenge. It is not uncommon that PES is refractory to dilation sessions. This study aimed at evaluating the efficacy of Mitomycin C (MMC) endoscopic injection for the treatment of refractory pharyngoesophageal stenosis.

Patients And Methods: This is a prospective study in patients with dysphagia following head and neck cancer treatment, without evidence suggestive of tumor recurrence, and refractory to endoscopic treatment. These patients were submitted to endoscopic dilation of the stenotic segment with thermoplastic bougies, followed by injection of MMC. We repeated the endoscopic sessions every three weeks.

Results: From January 2015 to May 2015, we treated 13 patients with PES. Three patients were initially enrolled in the study for refractory stricture. We observed adverse events in all of them, with intense neck pain and ulcer development, justifying the interruption of the trial.

Conclusion: The repeated injection in the short interval of MMC in refractory PES is not recommended, because it resulted in serious adverse events.

Citing Articles

Endoscopic management of benign recalcitrant esophageal strictures.

Boregowda U, Goyal H, Mann R, Gajendran M, Patel S, Echavarria J Ann Gastroenterol. 2021; 34(3):287-299.

PMID: 33948052 PMC: 8079876. DOI: 10.20524/aog.2021.0585.

Endoscopic postdilatation application of Mitomycin C in children with resistant esophageal strictures.

Rashed Y, El-Guindi M Korean J Pediatr. 2019; 62(10):395-399.

PMID: 31319649 PMC: 6801201. DOI: 10.3345/kjp.2018.07157.

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