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Background <p>Radiotherapy (RT) is preferred over stent placement for dysphagia in unresectable esophageal squamous cell carcinoma (ESCC); however, low-radial-force self-expandable metallic stents (SEMS) may offer safer and more effective palliation. We aimed to compare the outcomes of RT and low-radial-force SEMS in ESCC patients.</p> Methods <p>This retrospective study included patients with unresectable ESCC and dysphagia who underwent palliative RT or low-radial-force SEMS placement between 2013 and 2023. Adverse events were compared, and treatment efficacy was assessed based on changes in Dysphagia Score (DS) and the duration of maintaining DS ≤ 1 among those who achieved it.</p> Results <p>The stent and RT groups comprised 34 and 45 patients, respectively. Treatment-related adverse events of Grade ≥ 2 and ≥ 3 occurred in 29.4% and 5.8% in the stent group and 34.9% and 6.7% in the RT group, respectively, with no significant differences. After adjustment for baseline DS, the stent group showed significantly greater improvement at 1 month (<i>p</i> &lt; 0.001), whereas no differences were observed at 2 or 3 months. DS ≤ 1 was achieved in 76.5% with stent and 44.4% with RT (<i>p</i> = 0.006). Maintenance of DS ≤ 1 was shorter with stent group when additional SEMS placement was considered an event (<i>p</i> = 0.006), whereas no difference was observed when additional SEMS was allowed (<i>p</i> = 0.898).</p> Conclusion <p>Low-radial-force SEMS is safe and effective for dysphagia in unresectable advanced ESCC, especially when early oral intake is needed, and can help prolong oral intake if additional SEMS is allowed.</p>

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Treatment outcomes of low-radial-force self-expandable metal stent placement and palliative radiotherapy for unresectable advanced esophageal squamous cell carcinoma with dysphagia

  • 期刊论文

  • 发表日期：

    2026年5月13日

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  • Koyo Kido,
  • Toshiyuki Yoshio,
  • Takashi Sasaki,
  • Chika Fukuyama,
  • Hiroyuki Yamamoto,
  • Yusuke Horiuchi,
  • Akiyoshi Ishiyama,
  • Kenji Tokumasu,
  • Mariko Ogura,
  • Keisho Chin,
  • Naoki Sasahira,
  • Hayato Nakagawa,
  • Toshiaki Hirasawa

摘要

Background

Radiotherapy (RT) is preferred over stent placement for dysphagia in unresectable esophageal squamous cell carcinoma (ESCC); however, low-radial-force self-expandable metallic stents (SEMS) may offer safer and more effective palliation. We aimed to compare the outcomes of RT and low-radial-force SEMS in ESCC patients.

Methods

This retrospective study included patients with unresectable ESCC and dysphagia who underwent palliative RT or low-radial-force SEMS placement between 2013 and 2023. Adverse events were compared, and treatment efficacy was assessed based on changes in Dysphagia Score (DS) and the duration of maintaining DS ≤ 1 among those who achieved it.

Results

The stent and RT groups comprised 34 and 45 patients, respectively. Treatment-related adverse events of Grade ≥ 2 and ≥ 3 occurred in 29.4% and 5.8% in the stent group and 34.9% and 6.7% in the RT group, respectively, with no significant differences. After adjustment for baseline DS, the stent group showed significantly greater improvement at 1 month (p < 0.001), whereas no differences were observed at 2 or 3 months. DS ≤ 1 was achieved in 76.5% with stent and 44.4% with RT (p = 0.006). Maintenance of DS ≤ 1 was shorter with stent group when additional SEMS placement was considered an event (p = 0.006), whereas no difference was observed when additional SEMS was allowed (p = 0.898).

Conclusion

Low-radial-force SEMS is safe and effective for dysphagia in unresectable advanced ESCC, especially when early oral intake is needed, and can help prolong oral intake if additional SEMS is allowed.