PMID- 37039273 OWN - NLM STAT- MEDLINE DCOM- 20231003 LR - 20231003 IS - 1442-2050 (Electronic) IS - 1120-8694 (Linking) VI - 36 IP - 10 DP - 2023 Sep 30 TI - Impact of radiotherapy on adverse events of self-expanding metallic stents in patients with esophageal cancer. LID - doad019 [pii] LID - 10.1093/dote/doad019 [doi] AB - 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. CI - (c) 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. FAU - Machado, Andressa A AU - Machado AA AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Martins, Bruno C AU - Martins BC AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Josino, Iatagan R AU - Josino IR AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Chen, Andre T C AU - Chen ATC AD - Department of Radiotherapy, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Hong, Carlos B C AU - Hong CBC AD - Department of Radiotherapy, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Santos, Alisson L D R AU - Santos ALDR AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Lima, Gustavo R A AU - Lima GRA AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Cordero, Martin A C AU - Cordero MAC AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Safatle-Ribeiro, Adriana V AU - Safatle-Ribeiro AV AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Pennacchi, Caterina AU - Pennacchi C AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Gusmon, Carla C AU - Gusmon CC AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Paulo, Gustavo A AU - Paulo GA AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Lenz, Luciano AU - Lenz L AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Lima, Marcelo S AU - Lima MS AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Baba, Elisa R AU - Baba ER AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Kawaguti, Fabio S AU - Kawaguti FS AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Uemura, Ricardo S AU - Uemura RS AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Sallum, Rubens A A AU - Sallum RAA AD - Department of Gastroenterology, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Ribeiro, Ulysses Jr AU - Ribeiro U Jr AD - Department of Gastroenterology, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. FAU - Maluf-Filho, Fauze AU - Maluf-Filho F AD - Endoscopy Unit, Cancer Institute of Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil. LA - eng PT - Journal Article PL - United States TA - Dis Esophagus JT - Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus JID - 8809160 SB - IM MH - Humans MH - Retrospective Studies MH - Treatment Outcome MH - Stents/adverse effects MH - *Esophageal Neoplasms/therapy/complications MH - *Deglutition Disorders/etiology/therapy MH - Palliative Care MH - *Self Expandable Metallic Stents/adverse effects MH - *Esophageal Stenosis/therapy OTO - NOTNLM OT - esophageal cancer OT - esophageal stent OT - radiotherapy EDAT- 2023/04/12 06:00 MHDA- 2023/10/03 06:47 CRDT- 2023/04/11 07:03 PHST- 2022/10/09 00:00 [received] PHST- 2023/01/03 00:00 [revised] PHST- 2023/10/03 06:47 [medline] PHST- 2023/04/12 06:00 [pubmed] PHST- 2023/04/11 07:03 [entrez] AID - 7111524 [pii] AID - 10.1093/dote/doad019 [doi] PST - ppublish SO - Dis Esophagus. 2023 Sep 30;36(10):doad019. doi: 10.1093/dote/doad019.