TY - JOUR
T1 - Esophageal stenting and radiotherapy
T2 - A multimodal approach for the palliation of symptomatic malignant dysphagia
AU - Rueth, Natasha M.
AU - Shaw, Darcy
AU - D'Cunha, Jonathan
AU - Cho, L. Chinsoo
AU - Maddaus, Michael A
AU - Andrade, Rafael S
PY - 2012/12/1
Y1 - 2012/12/1
N2 - Background. Esophageal stents provide immediate palliation of malignant dysphagia; however, radiotherapy (RT) is a superior long-term option. We review the outcomes of combined esophageal stenting and RT for patients with malignant dysphagia. Methods. We retrospectively reviewed patients with esophageal stents placed for palliation of malignant dys-phagia from esophageal stricture, esophageal extrinsic compression, or malignant tracheoesophageal fistula (TEF). We excluded patients with radiation-induced TEF in the absence of tumor. We analyzed and compared outcomes between patients with no RT, RT before stent placement, and RT after stent placement. Results. We placed stents in 45 patients for esophageal stricture from esophageal cancer (n = 30; 66.7 %), malignant TEF (n = 8; 17.7 %), and esophageal compression from airway, mediastinal, or metastatic malignancies (n = 7; 15.6 %). Twenty patients (44.4 %) had no RT; 25 patients had RT before stent placement (n = 16; 35.6 %), RT after stent placement (n = 8; 17.8 %), or both (n = 1; 2.2 %). Median follow-up was 30 days. Complications requiring stent revision were similar with or without RT. Subjective symptom relief was achieved in 68.9 % of all patients, with no differences noted between groups (p = 0.99). The 30-day mortality was 15.6 %. Patients with RT after stent placement had a longer median survival compared to those without RT (98 vs. 38 days). Conclusions. Esophageal stent placement with RT is a safe approach for malignant dysphagia.
AB - Background. Esophageal stents provide immediate palliation of malignant dysphagia; however, radiotherapy (RT) is a superior long-term option. We review the outcomes of combined esophageal stenting and RT for patients with malignant dysphagia. Methods. We retrospectively reviewed patients with esophageal stents placed for palliation of malignant dys-phagia from esophageal stricture, esophageal extrinsic compression, or malignant tracheoesophageal fistula (TEF). We excluded patients with radiation-induced TEF in the absence of tumor. We analyzed and compared outcomes between patients with no RT, RT before stent placement, and RT after stent placement. Results. We placed stents in 45 patients for esophageal stricture from esophageal cancer (n = 30; 66.7 %), malignant TEF (n = 8; 17.7 %), and esophageal compression from airway, mediastinal, or metastatic malignancies (n = 7; 15.6 %). Twenty patients (44.4 %) had no RT; 25 patients had RT before stent placement (n = 16; 35.6 %), RT after stent placement (n = 8; 17.8 %), or both (n = 1; 2.2 %). Median follow-up was 30 days. Complications requiring stent revision were similar with or without RT. Subjective symptom relief was achieved in 68.9 % of all patients, with no differences noted between groups (p = 0.99). The 30-day mortality was 15.6 %. Patients with RT after stent placement had a longer median survival compared to those without RT (98 vs. 38 days). Conclusions. Esophageal stent placement with RT is a safe approach for malignant dysphagia.
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U2 - 10.1245/s10434-012-2459-3
DO - 10.1245/s10434-012-2459-3
M3 - Review article
C2 - 22752374
AN - SCOPUS:84876489663
SN - 1068-9265
VL - 19
SP - 4223
EP - 4228
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 13
ER -