Radiotherapy necessary for patients with advanced esophageal cancer after stent placed?

Radiotherapy necessary for patients with advanced esophageal cancer after stent placed? Recently, a new study found that for patients with advanced esophageal cancer with stent implantation, palliative care is more helpful than radiotherapy to maintain the quality of life, and radiotherapy has no positive effect on the survival rate of such patients.

This study, published in The Lancet, Gastroenterology and Hepatology, is the first study to evaluate the effects of radiotherapy after stent placement for esophageal cancer on the eating ability and survival rate of patients.

▌Esophageal cancer has a lot to do with eating habits

Esophageal cancer is the seventh leading cancer in the world and the sixth leading cause of cancer death. In 2020, there will be approximately 600,000 newly confirmed cases worldwide. some countries alone accounted for more than 320,000, and the death toll exceeded 300,000 (540,000 worldwide).

The high incidence of esophageal cancer has a lot to do with some bad eating habits, such as smoked and preserved foods, the eating habit of “eat while it is hot”, smoking and drinking.

American oncologist Dr. Edward Wagner pointed out that currently, the treatment of esophageal cancer has formed a comprehensive treatment model with surgical treatment as the mainstay, adjuvant radiotherapy, chemotherapy, etc. However, 25% of patients still have advanced stages and lose the opportunity for surgery. The treatment options are very high. Limited, the prognosis is poor, and the median survival time is only 3-6 months.

In addition, because the esophagus is blocked by tumors, it is difficult to swallow and cannot eat and drink normally, which seriously affects the quality of life. For this type of esophageal cancer patients, self-expanding metal stent (SEMS) implantation is an ideal choice, which can quickly relieve the symptoms of esophageal obstruction, improve nutritional status, and improve the quality of life and survival.

However, worsening symptoms of dysphagia and reinsertion of stents are more common. After stent placement, some advanced patients hope to extend their survival period through radiotherapy, prevent symptoms from worsening and reoperation, and improve their quality of life. However, is this necessary?

▌Patients with advanced esophageal cancer can avoid the pain of radiotherapy

This five-year new study was funded by the National Institutes of Health in the United Kingdom and was carried out in 23 centers in the United Kingdom. It enrolled 220 patients and was designed to determine whether radiotherapy can improve the swallowing function and life of patients with advanced esophageal cancer with stents quality.

“We want to figure out: How to help these patients make the most of the remaining time and maintain the best quality of life as possible? Is radiotherapy worth it?”

The results proved that radiotherapy increased the disease burden of patients (severe dysphagia symptoms, readmission rate, etc.), and did not improve the survival rate.

In this regard, the researchers concluded: radiotherapy should not be used as a conventional treatment for such patients.

The researchers also suggest that when patients with advanced esophageal cancer receive stent therapy for the first time, they should be supported by multidisciplinary collaboration. In addition, in the past, these patients were often excluded from clinical trials. This study highlights the importance of high-quality clinical research for end-stage patients. Although this type of clinical research is more difficult, it can guide clinicians to choose the most appropriate treatment and protect patients from unnecessary side effects.

This study explores important issues about the quality of life of end-stage cancer patients and the need for open and honest communication between clinicians and patients on the correct treatment plan.

(source:internet, reference only)

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