Does an esophageal stent impact your radiation treatment plan for a patient with non-metastatic GE junction adenocarcinoma?

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 ...

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.

I agree with Drs. @Dr. First Last, @Dr. First Last, and @Dr. First Last.

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 sev...

I agree with Dr. @Dr. First Last and Dr. @Dr. First Last. 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.

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’t want...

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 treatment. Ste...