Self-expandable metallic stent placement for patients with inoperable esophageal carcinoma: investigation of the influence of prior radiotherapy and chemotherapy.
OBJECTIVE
The aim of this study was to evaluate the efficacy and complications of self-expandable metallic stent placement for patients with inoperable esophageal carcinoma after radiotherapy and/or chemotherapy.


METHODS
We obtained data from 19 patients with advanced or recurrent esophageal carcinoma between 1996 and 2000. In all patients, a self-expandable metallic stent was placed under fluoroscopic guidance. Dysphagia before and after stent placement was graded. Complications after stent placement were also evaluated. Data were compared between patients with and without prior radiotherapy and/or chemotherapy.


RESULTS
The procedure was technically successful in all but one patient. The dysphagia grade improved in all patients. No life-threatening complications occurred. The other major complications such as mediastinitis occurred in two patients, and pneumonia and funnel phenomenon occurred in one patient each. These patients had a history of radiotherapy and/or chemotherapy prior to stent placement. Eight of the twelve patients with prior radiotherapy and/or chemotherapy compared with one of seven patients without prior therapy had persistent chest pain, which was a statistically significant difference (P < 0.05).


CONCLUSIONS
Placement of self-expandable metallic stents was effective for patients with advanced or recurrent esophageal carcinoma. However, prior irradiation and/or chemotherapy increased the risk of persistent chest pain after stent placement.
Iraha
Yuko
Y
Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nakagami-gun, Okinawa, Japan.
Murayama
Sadayuki
S
Toita
Takafumi
T
Utsunomiya
Takashi
T
Nagata
Osamu
O
Akamine
Tamaki
T
Ogawa
Kazuhiko
K
Adachi
Genki
G
Tanigawa
Noboru
N
D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology / Q000517:prevention & control*; D004358:Drug Therapy; D004938:Esophageal Neoplasms / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D007440:Intubation / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008670:Metals; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011878:Radiotherapy; D015607:Stents; D016896:Treatment Outcome
D008670:Metals