There was no improvement in these outcomes for B-Raf assay patients treated with brachytherapy. In an interim inter-group analysis at one mo a significant improvement in dysphagia scale favored the SEMS group. At three mo, some of the dysphagia-related parameters continued to show clinical improvement in the SEMS group but these did not achieve statistical significance. In the brachytherapy group, clinically significant improvements were noted in some of the parameters related to dysphagia at three mo and these Inhibitors,research,lifescience,medical were maintained at six mo.

However, these data did not achieve statistical significance. General health QoL was measured using the EORTC QLQ-30 scale. In the stent group all functional scales and single symptom scales deteriorated Inhibitors,research,lifescience,medical compared to mean scores at inclusion. The largest deterioration was found for social function, followed by pain, role function and insomnia. In the brachytherapy group, a clinically relevant deterioration was found for most variables on the function and single symptom scales with physical function, global QoL and pain scales reaching statistical significance. Madhusudhan et al. (45) in their prospective study assessed the QoL using EORTC QLQ-C30 (version 3) and EORTC QLQ-OES 18 questionnaires before stenting, and at one, four and eight wk following placement of the stent. The results showed significant improvement following Inhibitors,research,lifescience,medical stenting. The general health

scale and function scores increased significantly. Most symptom scores, except pain, showed improvement. The pain score deteriorated at one wk, as initial expansion of SEMS following Inhibitors,research,lifescience,medical its placement led to an increase in pain sensation. Over a period of two mo, the pain scores decreased to baseline values. The financial strain scores also showed a significant improvement. The studies did not specifically address Inhibitors,research,lifescience,medical the influence of stents on patient QoL; although anecdotally we have extrapolated that improved swallowing will

result in improved QoL. Improvement of dysphagia is likely a result of stent placement along with decreased tumor burden from neoadjuvant therapy. A generous decrease in the dysphagia scores SDM –0.81 was observed in our investigation. Other applications of stent implantation in perioperative and postoperative care of the carcinoma of the esophagus Removable self-expanding silicone stents have previously demonstrated utility for relieving dysphagia from benign strictures and from second both resectable and unresectable malignant disease (27,46-49). University Medical Centre Utrecht (50) performed a pooled analysis regarding placement of fully covered and partially covered SEMS (FSEMS and PSEMS) and SEPS for treating benign esophageal ruptures and anastomotic leaks. Twenty-five studies, including 267 patients with complete follow-up on outcome, were identified. Clinical success was achieved in 85% of patients and was not different between stent types (SEPS 84%, FSEMS 85% and PSEMS 86%, P=0.97).