title: Evaluation of quality of life following placement of self-expanding plastic stents as a bridge to surgery in patients receiving neoadjuvant therapy for esophageal cancer.
abstract: OBJECTIVE
  To determine whether self-expanding plastic stent (SEPS) placement significantly improves quality of life and maintains optimal nutrition while allowing full-dose neoadjuvant therapy (NAT) in patients with esophageal cancer.
  
  
  METHODS
  A prospective, dual-institution, single-arm, phase II (http://ClinicalTrials.gov: NCT00727376) evaluation of esophageal cancer patients undergoing NAT prior to resection. All patients had a self-expanding polymer stent placed prior to NAT. The European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-OG25, Functional Assessment of Cancer Therapy-Anorexia, and Functional Assessment of Cancer Therapy-General surveys were administered prior to stenting, within 1 week post-stent placement, and at the completion of neoadjuvant therapy.
  
  
  RESULTS
  Fifty-two patients were enrolled; 3 (5.8%) had stent migrations requiring replacement. There were no instances of esophageal erosion or perforation. All patients received some form of neoadjuvant therapy. Thirty-six (69%) received chemoradiation; 34 (93%) of these patients received the planned dose of chemotherapy, and 27 (75%) received the full planned dose of radiotherapy. There were 16 (31%) patients receiving chemotherapy alone; 12 (74%) of patients in the chemotherapy-alone group completed the planned dose of therapy.
  
  
  CONCLUSIONS
  Placement of SEPS appears to provide significant improvement in quality of life related to dysphagia and eating restriction in patients with esophageal cancer undergoing neoadjuvant therapy. Consideration of SEPS instead of percutaneous feeding tube should be initiated as a first line in dysphagia palliation and NAT nutritional support.
authors.affiliation: University of Louisville, Department of Surgery, Division of Surgical Oncology, Louisville, Kentucky, USA; Department of Surgery, Ochsner Medical Center, Ochsner Health Systems, New Orleans, Louisiana, USA.
authors.forename: Robert C G
authors.initials: RC
authors.lastname: Martin
authors.forename: Robert M
authors.initials: RM
authors.lastname: Cannon
authors.forename: Russell E
authors.initials: RE
authors.lastname: Brown
authors.forename: Susan F
authors.initials: SF
authors.lastname: Ellis
authors.forename: Sharon
authors.initials: S
authors.lastname: Williams
authors.forename: C R
authors.initials: CR
authors.lastname: Scoggins
authors.forename: Abbas E
authors.initials: AE
authors.lastname: Abbas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000473:pathology / Q000523:psychology* / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010166:Palliative Care; D011446:Prospective Studies; D011788:Quality of Life; D015607:Stents; D016896:Treatment Outcome
keywords: Esophageal cancer; Esophageal stenting; Neoadjuvant therapy; Quality of life