Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Baumgartner, E.
Palliative Therapie des Ösophaguskarzinoms. Analyse von Therapiemodalitäten & Überlebenszeit.
[ Diplomarbeit/Master Thesis ] Graz Medical University; 2009. pp.73.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Lindenmann Jörg
- Smolle-Juettner Freyja-Maria
- Altmetrics:
- Abstract:
- Background More than 50% of all carcinoma of the esophagus are diagnosed at a stage where only palliative modalities of therapy can be offered. We wanted to have a closer look on those therapies and, at the same time, evaluate their impact on the mean survival time of our patients. Out of this reason, we conducted a single centre study at the Division of Thoracic and Hyperbaric Surgery at the Department of Surgery, Medical University of Graz. Methods After examination of the endoscopy-books of the years 1999 2009, evaluation of the mode of therapy and the parameters relevant for our study by browsing either Medocs or clinical records, 250 out of 640 patients met the inclusion criteria. Those datasets were statistically evaluated after anonymisation. Results Collectively, there were 250 patients treated by palliative therapy for the reason of esophageal carcinoma. Amongst them were 37 women (14,9%) and 211 men (85,1%). Initially, Photodynamic Therapy (PDT) was applied in 118 out of 247 cases (47,2%), esophageal stenting in 36 out of 247 cases (14,4%), esophageal dilatation in 24 out of 247 cases (9,6%); chemotherapy was applied in 29 out of 247 cases (11,7%) as initial therapy. Mean survival time for patients treated at the Division of Thoracic and Hyperbaric Surgery at the Department of Surgery, Medical University of Graz was set at 34 months. Localisation of the tumour had no impact on survival time. Although tumour growth in the mid third of the esophagus was shown to come along with a poorer prognosis (mean survival time 23,2 months) than tumour growth in the upper and lower third ( 29,6 respectively 28,8 months), a statistically significant difference could not be found (p=0,638). Mean survival time for PDT as initial modality of therapy were 50,9 months (p=0,012) in comparison to a total survival time of 34 months. Conclusio In our study, Photodynamic Therapy emerges to be the only treatment significantly enhancing the mean overall survival. So far, PDTs impact on the immune system, both in a stimulating and suppressive way, was only examined by the use of mice models clinical trials showing reproducible results are yet carried out scarcely. Nevertheless, the tendency to have a very interesting and promising modality for the palliative treatment of esophageal carcinoma at ones disposal by using the photodynamic therapy can be clearly seen.