The role of laser therapy in the palliative treatment of esophageal cancer.

Laser has become in the recent years an important therapeutic tool for treating esophageal cancer in a palliative setting aiming to reopen the tumor stenosis. The literature shows that the initial enthusiasm for laser, compared with other methods--especially endoprosthesis--has somewhat been tempered because the success rate in restoring a normal food intake was lower than expected (65-68%). Although the complication rate is low, repeated therapy sessions are needed to maintain the lumen open. This constitutes a major drawback in terms of patient acceptability. Variations in the therapeutical methods (contact laser, photodynamic therapy, ...) have not added up to now significant value to laser therapy. Specific indications for laser therapy versus endoprosthesis are discussed and should bring both therapeutic modalities to a more considered application.