Emily Adams, Héloïse Lavoie-Gagnon, Farhana Islam, Michael Humer, Benjamin Mou, Theodora A Koulis, David Kim, Siavash Atrchian
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引用次数: 0
Abstract
Purpose: Self-expandable metallic stents (SEMS) provide immediate but nondurable dysphagia relief in esophageal cancer, while external beam radiotherapy (EBRT) provides slower, more durable dysphagia relief. While the combination of SEMS with EBRT would seem to offer both rapid and durable dysphagia relief in the palliative setting, there remains controversy on its safety and efficacy. We investigated patient outcomes regarding EBRT after SEMS placement in patients with incurable esophageal cancer at a regional Canadian cancer program.
Methods: We conducted a single-centre retrospective chart review from January 2010 to July 2020 to compare stent-related complications and survival in patients with incurable esophageal cancer treated with SEMS alone or SEMS + EBRT at Kelowna General Hospital.
Results: 66 patients were included in the SEMS alone group and 26 in the SEMS + EBRT group. Patients treated with SEMS alone showed an average of 3.05 fewer stent-related complications compared to patients who received SEMS + EBRT. The SEMS alone group also had 9.05 greater odds of experiencing higher grade complications compared to the SEMS + EBRT group (p < 0.001). Patients in the SEMS + EBRT group survived significantly longer than those treated with SEMS alone, with a median overall survival of 163.5 days and 65 days, respectively.
Conclusions: SEMS monotherapy was associated with significantly fewer, yet higher grade stent-related complications compared to palliative EBRT after SEMS placement. SEMS + EBRT treatment was associated with significantly prolonged survival compared to SEMS alone. Prospective studies are needed to confirm these findings.
期刊介绍：
The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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