A retrospective study comparing expandable metal stenting with radiation therapy in advanced oesophageal carcinoma in a regional South African hospital

Abstract

Oesophageal cancer causes much morbidity and mortality in South Africa. This disease has a 5-year survival of less than 10% despite improvements in therapy. Most patients present with advanced disease and are suitable only for palliative care. Current standard of palliative care for patients with end-stage oesophageal cancer that present with dysphagia include brachytherapy and stenting. Brachytherapy improves survival and has a more stable quality of life in the long term when compared to stenting. Conversely stenting has a more acute relief of dysphagia. In South Africa many patients with malignant dysphagia face socio-economic constraints that cause delays in therapy, especially in patients from rural areas. Many prospective randomized trials of palliative treatment have been done in the developed world, not taking into account socio-economic constraints. We present a study from Tshepong Hospital (Klerksdorp, North West province), a secondary hospital in South Africa.