Sa1285 IMPACT OF RADIOTHERAPY (RT) ON ADVERSE EVENTS OF SELF-EXPANDING METALLIC STENTS (SEMS) IN PATIENTS WITH ESOPHAGEAL CANCER

Abstract

Introduction: SEMS are considered the best treatment for palliation of dysphagia and fistulas in inoperable esophageal neoplasms. However, the safety of SEMS in patients who received RT is uncertain. Aim: to evaluate the impact of RT on adverse events after SEMSs placement in the palliative treatment of patients with esophageal cancer. Methods: this is a retrospective study based on a prospectively collected database, conducted at the Instituto do Câncer do Estado de São Paulo (ICESP) from 2009 to 2018. We collected information about performance of RT before or after endoscopic procedure, histological type of lesion, model of SEMS and adverse events after stent placement. Statistical analysis was performed using odds ratio and 95% CI. Results: a total of 372 patients with malignant stenosis or fistula were treated with SEMS placement. The predominant histological type was squamous cell carcinoma (77.4%). Concerning the SEMS model, 317 partially covered and 55 fully covered SEMS were used. From the 372 patients, 213 received RT (170 before, 35 after and 8 before and after SEMS) and 159 patients did not. In Table 1, patients characteristics can be observed. The comparison of adverse events rate of esophageal SEMS in the radiotherapy group (RT) versus the non-radiotherapy group (NRT) can be observed in Table 2. Conclusion: RT did not increase the adverse events rate after SEMS placement, except the risk for severe pain.

Self-expandable metallic stent-induced esophagorespiratory fistulas in patients with advanced esophageal cancer

“…A recent guideline 20 advises against stent placement concomitant with RT. However, our experience 21 is in agreement with other studies 22 that reported that only minor AEs (mainly mild chest pain) occurred more frequently in patients receiving RT. Regarding the risk of ERF, Bick et al 6 showed a 9.4-fold greater chance of ERF development in patients with a history of RT.…”