Impact of radiotherapy on adverse events of self-expanding metallic stents in patients with esophageal cancer.

Autor: Machado AA; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Martins BC; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Josino IR; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Chen ATC; Department of Radiotherapy, Cancer Institute of Sao Paulo, University of Sao Paulo, São Paulo, Brazil., Hong CBC; Department of Radiotherapy, Cancer Institute of Sao Paulo, University of Sao Paulo, São Paulo, Brazil., Santos ALDR; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Lima GRA; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Cordero MAC; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Safatle-Ribeiro AV; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Pennacchi C; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Gusmon CC; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Paulo GA; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Lenz L; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Lima MS; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Baba ER; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Kawaguti FS; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Uemura RS; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil., Sallum RAA; Department of Gastroenterology, Cancer Institute of Sao Paulo, University of Sao Paulo, São Paulo, Brazil., Ribeiro U Jr; Department of Gastroenterology, Cancer Institute of Sao Paulo, University of Sao Paulo, São Paulo, Brazil., Maluf-Filho F; Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus [Dis Esophagus] 2023 Sep 30; Vol. 36 (10).
DOI: 10.1093/dote/doad019
Abstrakt: Self-expanding metallic stents (SEMS) are considered the treatment of choice for the palliation of dysphagia and fistulas in inoperable esophageal neoplasms. However, the safety of SEMSs in patients who received or who will be submitted to radiotherapy (RT) is uncertain. The study aimed to evaluate the impact of RT on adverse events (AEs) in patients with esophageal cancer with SEMSs. This is a retrospective study conducted at a tertiary cancer hospital from 2009 to 2018. We collected information regarding RT, the histological type of the tumor, the model of SEMSs and AEs after stent placement. Three hundred twenty-three patients with malignant stenosis or fistula were treated with SEMSs. The predominant histological type was squamous cell carcinoma (79.6%). A total of 282 partially covered and 41 fully covered SEMSs were inserted. Of the 323 patients, 182 did not received RT, 118 received RT before SEMS placement and 23 after. Comparing the group that received RT before stent insertion with the group that did not, the first one presented a higher frequency of severe pain (9/118 7.6% vs. 3/182 1.6%; P = 0.02). The group treated with RT after stent placement had a higher risk of global AEs (13/23 56.5% vs. 63/182 34.6%; P = 0.019), ingrowth/overgrowth (6/23 26.1% vs. 21/182 11.5%; P = 0.045) and gastroesophageal reflux (2/23 8.7% vs. 2/182 1.1%; P = 0.034). Treatment with RT before stent placement in patients with inoperable esophageal neoplasm prolongs survival and is associated with an increased risk of severe chest pain. Treatment with RT of patients with an esophageal stent increases the frequency of minor, not life-threatening AEs.
(© The Author(s) 2023. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze: MEDLINE
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