Does an esophageal stent impact your radiation treatment plan for a patient with non-metastatic GE junction adenocarcinoma?
In general, how does an esophageal stent affect what you might consider in terms of radiation dose and volume?
Answer from: Radiation Oncologist at Academic Institution
While the presence of a stent might not directly affect my radiation dose and volumes, due to numerous other considerations, it would certainly affect my overall treatment plan. I highly encourage avoiding a stent in the setting of radiation due to toxicity concerns in addition to the complications ...
Comments
Radiation Oncologist at Washington University School of Medicine I've had similar experiences with rectal stents as...
Radiation Oncologist at OSF HealthCare Cancer Institute Dr. @Anker,
Excellent comprehensive answer. This ...
Answer from: Radiation Oncologist at Community Practice
In general, I try and avoid stents. While it does not impact my treatment planning, I do have concerns for perforation or stent migration. So the management of these patients can be more involved given the risk for a series of complications.
Answer from: Radiation Oncologist at Academic Institution
I agree with Drs. @Anker, @Romesser, and @Meyer.I also did some literature search. Based on some published study results, esophageal stenting can indeed impact the radiation treatment plan for patients with non-metastatic GE junction adenocarcinoma. These studies indicate several key findings:
Comp...
Answer from: Radiation Oncologist at Academic Institution
I agree with Dr. @Anker and Dr. @Romesser. I would only add that a stent across the GE junction is frequently very poorly tolerated, with severe reflux that is refractory to medication. Additionally, the further the stent extends into the stomach, the more likely it is to migrate.
Answer from: Radiation Oncologist at Community Practice
At the end of the 1990s, the Digestive Disease Ce meter and Rad Onc MUSC spearheaded a trial STent or palliative RT (20 Gy 5 Fx). It was sponsored by Boston Scientific. A lot of balking at 20 Gy, but MST was 4 mos. Only 30 patients were entered. I reported at ASTRO but the GI fold and BS didn’...
Answer from: Radiation Oncologist at Community Practice
Excellent thread here on esophageal stenting.
I reserve stenting as the last resort for palliation, especially if there are no radiotherapy options.
For curative intent chemorads patients - supporting them with G-tube, TPN, and hydration is more critical and getting them through the tr...
I've had similar experiences with rectal stents as...
Dr. @Anker, Excellent comprehensive answer. This ...