Prospective Cohort Study of Palliative Treatment of Esophageal Cancer with Liquid Nitrogen Spray Cryotherapy.

Document Type

Article

Publication Date

1-16-2026

Publication Title

Gastrointestinal Endoscopy

Abstract

BACKGROUND AND AIMS: Palliation of dysphagia associated with advanced esophageal cancer is challenging. Previous studies suggest liquid-nitrogen spray cryotherapy (LNSC) is effective to palliate obstructive esophageal cancer. We sought to prospectively examine the utility, safety, and efficacy of serial applications of repeated palliative LNSC in this population.

METHODS: We performed a prospective cohort trial of LNSC for persistent esophageal cancer without the possibility of resection for palliation of obstructive symptoms. We used repeated measures and competing risks analyses to study the course of patients treated over two years. Efficacy of treatment was assessed using quality-of-life scores 14 days after treatment, using general cancer (QLQ-C30) and esophageal cancer-specific (QLQ-OES18) quality-of-life questionnaires, as well as ordinal dysphagia scores. Complications were assessed using structured interviews and classified according to Common Terminology Criteria.

RESULTS: On repeated treatments, each participant (N = 49) improved their QLQ-C30 score by a mean 1.7 (95% confidence interval (CI) 0.1 - 3.3) and improved their QLQ-OES18 score by a mean 1.8 (95% CI 0.4-3.3). For each subsequent round of treatment, the effect improved 0.1 (95% CI 0.3-0.4) for the QLQ-C30 score and worsened -0.2 (95% CI -0.5 - 0.2) for QLQ-OES18 score. There was no signifcant improvement in the ordinal dysphagia score. 19 (39.6%) of 48 participants with a feedng tube at baseline required a feeding tube or stent at a mean of 8 months. While unrelated serious adverse events were common (38.8%), only two patients had events possibly related to LNSC (4.1%, melena and dysphagia).

CONCLUSIONS: Spray cryotherapy had a durable and repeatable benefit for palliation of obstructive symptoms of esophageal cancer and quality of life in the majority of patients, without the need for feeding tube or esophageal stent placement. Treatments were generally well-tolerated.

DOI

10.1016/j.gie.2025.12.291

ISSN

1097-6779

PubMed ID

41548722

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