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Endoscopy 2007; 39(7): 637-642
DOI: 10.1055/s-2007-966571
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Prospective nonrandomized comparison of two modes of argon beamer (APC) tumor desobstruction: effectiveness of the new pulsed APC versus forced APC

A.  Eickhoff1 , R.  Jakobs1 , D.  Schilling1 , D.  Hartmann1 , U.  Weickert1 , M.  D.  Enderle2 , J.  C.  Eickhoff3 , J.  F.  Riemann1
  • 1Medical Department C, Klinikum Ludwigshafen GmbH, Ludwigshafen, Germany
  • 2ERBE Elektromedizin GmbH, Tübingen, Germany
  • 3Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, USA
Further Information

Publication History

submitted 27 July 2006

accepted after revision 9 March 2007

Publication Date:
05 July 2007 (online)

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Commentaire de travail de A. Eickhoff et al., pp. 637Endoscopy 2007; 39(07): 760-760
DOI: 10.1055/s-0032-1306958

Background and study aim: Argon plasma coagulation (APC) has become an established noncontact method of tumor palliation in a variety of locations. The present prospective study evaluated a new APC system (APC-2) using amplified power settings and different application modes, such as intermittent energy delivery (pulsed APC) in comparison with the conventional technique (forced APC).

Patients and methods: A total of 100 patients with esophageal, gastric, or rectal tumors were alternately (but not randomized) enrolled and treated with either pulsed APC (n = 46) or forced APC (n = 54). Parameters to assess the palliative effect were: amount of lumen restoration (⅓, ⅔, complete), objective planimetry, stenosis length, treatment time, and number of APC sessions.

Results: Overall response rate was similar in both groups (pulsed 83 %, forced 87 %), the same was found in the subgroups with different amounts of lumen restoration and for the other objective parameters. However, the tumor debulking effect was achieved in a significantly shorter median treatment time with forced compared with pulsed APC (13.6 vs. 18.2 minutes, P = 0.03), with a similar number of treatment sessions in both groups. Complications also occurred with similar frequency in both groups.

Conclusions: There was no significant difference in overall local tumor response between the two modes of APC application. However, data from this nonrandomized study suggest a faster achievement of response with forced APC. A combination of both modes may be superior.

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A. Eickhoff, MD 

Medical Department C

Klinikum Ludwigshafen

Bremserstr. 79

67063 Ludwigshafen

Germany

Fax: +49-621-5034114

Email: eickhofa@klilu.de