title: Esophageal stenting and radiotherapy: a multimodal approach for the palliation of symptomatic malignant dysphagia.
abstract: 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 dysphagia 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.
authors: Division of General Thoracic and Foregut Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA. ruet0012@umn.edu
authors: Natasha M
authors: NM
authors: Rueth
authors: Darcy
authors: D
authors: Shaw
authors: Jonathan
authors: J
authors: D'Cunha
authors: Chinsoo
authors: C
authors: Cho
authors: Michael A
authors: MA
authors: Maddaus
authors: Rafael S
authors: RS
authors: Andrade
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000628:therapy*; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000150:complications / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D011379:Prognosis; D011878:Radiotherapy; D015607:Stents