A Retrospective Comparison of Radiotherapy and Stenting for the Relief of Dysphagia and Pain in Advanced Esophageal Cancer.

OBJECTIVES: The objective of this study was to compare the efficacy of external beam radiotherapy (EBRT) and self-expanding metal stents (SEMS) in relieving dysphagia and pain, while also evaluating their treatment-related adverse event profiles in patients with advanced esophageal cancer. MATERIALS AND METHODS: It is a retrospective review based on observations of 130 patients who presented with locally advanced esophageal cancer and were not fit to receive any curative treatment, and the only intention of treatment was symptom palliation, especially dysphagia and pain. RESULTS: We observed a significant and comparable improvement in dysphagia scores in both groups. Based on Ogilvie dysphagia scores, the mean pretreatment dysphagia score for the EBRT group was 2.6; for the SEMS group, it was 3; and respective dysphagia scores three to four months after the treatment were 1 for both groups. However, the same was not true for pain; the drop in median pain score at six months based on the Likert pain scale for the EBRT group was from 7.5 to 4, but for SEMS, the drop in pain score was only from 7 to 5. CONCLUSION: EBRT and esophageal SEMS are equally effective in relieving dysphagia, but the same is not true for pain. For patients with SEMS, pain remains a constant concern both for patient and physician. Hence, proper patient selection for either modality should be meticulously weighted based on symptomology.