{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:20:18Z","timestamp":1789842018653,"version":"4.0.1"},"reference-count":48,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T00:00:00Z","timestamp":1687305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Malignant dysphagia is a common problem in patients with esophageal cancer. Endoscopic stenting can resolve dysphagia caused by malignant stricture; however, controversy exists regarding the use of esophageal stenting for the treatment of malignant stricture, including whether stenting or radiotherapy is superior, whether stenting before or after radiotherapy is safe, whether stenting before or after chemotherapy is safe, and whether low-radial-force stents are safer than conventional stents. Among treatment options for malignant dysphagia, stenting may have some disadvantages in terms of pain relief and the risk of adverse events compared with radiotherapy and in terms of survival compared with gastrostomy. Additionally, the risk of stent-related adverse events is significantly associated with prior radiotherapy. The risk of perforation is especially high when a radiation dose of &gt;40 Gy is delivered to the esophagus after stenting, whereas perforation is not associated with prior chemotherapy or additional chemotherapy after stenting. Nevertheless, stenting remains an important palliative option, especially for patients with a short life expectancy and a strong desire for oral intake, because stenting can facilitate a more rapid improvement in dysphagia than radiotherapy or gastrostomy. The application of a low-radial-force stent should be considered to reduce the risk of adverse events, especially in patients with prior radiotherapy.<\/jats:p>","DOI":"10.3390\/curroncol30070447","type":"journal-article","created":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T02:29:18Z","timestamp":1687400958000},"page":"5984-5994","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Endoscopic Stenting for Malignant Dysphagia in Patients with Esophageal Cancer"],"prefix":"10.3390","volume":"30","author":[{"given":"Ryu","family":"Ishihara","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka 541-8567, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3322\/caac.21262","article-title":"Global cancer statistics, 2012","volume":"65","author":"Torre","year":"2015","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2383","DOI":"10.1016\/S0140-6736(17)31462-9","article-title":"Oesophageal cancer","volume":"390","author":"Lagergren","year":"2017","journal-title":"Lancet"},{"key":"ref_3","first-page":"365","article-title":"Palliation of malignant dysphagia in esophageal cancer, a literature-based review","volume":"4","author":"Javle","year":"2006","journal-title":"J. Support. Oncol."},{"key":"ref_4","first-page":"322","article-title":"Radiotherapy versus stenting in treating malignant dysphagia","volume":"3","author":"Eldeeb","year":"2012","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s10388-023-00993-2","article-title":"Esophageal cancer practice guidelines 2022 edited by the Japan esophageal society: Part 1","volume":"20","author":"Kitagawa","year":"2023","journal-title":"Esophagus"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s10388-023-00994-1","article-title":"Esophageal cancer practice guidelines 2022 edited by the Japan Esophageal Society, part 2","volume":"20","author":"Kitagawa","year":"2023","journal-title":"Esophagus"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kitagawa, Y., Ishihara, R., Ishikawa, H., Ito, Y., Oyama, T., Oyama, T., Kato, K., Kato, H., Kawakubo, H., and Kawachi, H. (2022). Esophageal Cancer Practice Guidelines 2022 Edited by the Japan Esophageal Society, Kanehara Publishing. [5th ed.]. (In Japanese).","DOI":"10.1007\/s10388-023-00994-1"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/S2468-1253(17)30363-1","article-title":"Palliative chemoradiotherapy versus radiotherapy alone for dysphagia in advanced oesophageal cancer: A multicentre randomised controlled trial (TROG 03.01)","volume":"3","author":"Penniment","year":"2018","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1016\/S0140-6736(04)17272-3","article-title":"Single-dose brachytherapy versus metal stent placement for the palliation of dysphagia from oesophageal cancer: Multicentre randomized trial","volume":"364","author":"Homs","year":"2004","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"569","DOI":"10.6004\/jnccn.2019.7524","article-title":"Palliative Radiotherapy Versus Esophageal Stent Placement in the Management of Patients with Metastatic Esophageal Cancer","volume":"18","author":"Martin","year":"2020","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Song, J.H., Ko, J., Min, Y.W., Kim, K., Lee, H., Min, B.-H., Lee, J.H., Rhee, P.-L., and Kim, J.J. (2020). Comparison between Percutaneous Gastrostomy and Self-Expandable Metal Stent Insertion for the Treatment of Malignant Esophageal Obstruction, after Propensity Score Matching. Nutrients, 12.","DOI":"10.3390\/nu12092756"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1111\/j.1365-2036.2006.02946.x","article-title":"Prior chemoradiotherapy is associated with a higher life-threatening complication rate after palliative insertion of metal stents in patients with oesophageal cancer","volume":"23","author":"Lecleire","year":"2006","journal-title":"Aliment. Pharm. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/S1051-0443(07)61722-9","article-title":"Retrievable covered nitinol stents: Experiences in 108 patients with malignant esophageal strictures","volume":"13","author":"Song","year":"2002","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"453","DOI":"10.2214\/AJR.10.5780","article-title":"Airway complications after covered stent placement for malignant esophageal stricture: Special reference to radiation therapy","volume":"198","author":"Park","year":"2012","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1111\/j.1442-2050.2012.01348.x","article-title":"The impact of prior radiotherapy on fatal complications after selfexpandable metallic stents (SEMS) for malignant dysphagia due to esophageal carcinoma","volume":"26","author":"Qiu","year":"2013","journal-title":"Dis. Esophagus"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.crad.2016.02.001","article-title":"Predictor of massive bleeding following stent placement for malignant oesophageal stricture\/fistulae: A multicentre study","volume":"71","author":"Liu","year":"2016","journal-title":"Clin. Radiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2560510","DOI":"10.1155\/2017\/2560510","article-title":"Comparison of Efficacy of Self-Expandable Metallic Stent Placement in the Unresectable Esophageal Cancer Patients","volume":"2017","author":"Uesato","year":"2017","journal-title":"Gastroenterol. Res. Pract."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1038\/s41598-021-81763-x","article-title":"Esophageal metal stent for malignant obstruction after prior radiotherapy","volume":"11","author":"Iwagami","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"47","DOI":"10.5009\/gnl16172","article-title":"Factors That Affect Stent-Related Complications in Patients with Malignant Obstruction of the Esophagus or Gastric Cardia","volume":"11","author":"Iwasaki","year":"2017","journal-title":"Gut Liver"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1007\/s00261-019-02245-3","article-title":"Clinical effectiveness and safety of self-expanding metal stent placement following palliative chemotherapy in patients with advanced esophageal cancer","volume":"45","author":"Bakheet","year":"2020","journal-title":"Abdom. Radiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s12029-010-9206-4","article-title":"Palliative stenting with or without radiotherapy for inoperable esophageal carcinoma: A randomized trial","volume":"43","author":"Javed","year":"2012","journal-title":"J. Gastrointest. Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/S2468-1253(21)00004-2","article-title":"Palliative radiotherapy after oesophageal cancer stenting (ROCS): A multicentre, open-label, phase 3 randomised controlled trial","volume":"6","author":"Adamson","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.3748\/wjg.v18.i12.1404","article-title":"Endoscopic stenting and concurrent chemoradiotherapy for advanced esophageal cancer: A case-control study","volume":"18","author":"Jiang","year":"2012","journal-title":"World J. Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.2214\/AJR.10.6306","article-title":"Polytetrafluoroethylene-covered retrievable expandable nitinol stents for malignant esophageal obstructions: Factors influencing the outcome of 270 patients","volume":"199","author":"Park","year":"2012","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_25","first-page":"24","article-title":"Treatment of medium and late stage esophageal carcinoma with combined endoscopic metal stenting and radiotherapy","volume":"116","author":"Zhong","year":"2003","journal-title":"Chin. Med. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1634\/theoncologist.2017-0646","article-title":"Esophageal Metal Stents with Concurrent Chemoradiation Therapy for Locally Advanced Esophageal Cancer: Safe or Not?","volume":"23","author":"Lu","year":"2018","journal-title":"Oncologist"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"4223","DOI":"10.1245\/s10434-012-2459-3","article-title":"Esophageal stenting and radiotherapy: A multimodal approach for the palliation of symptomatic malignant dysphagia","volume":"19","author":"Rueth","year":"2012","journal-title":"Ann. Surg. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.dld.2009.07.020","article-title":"Long-term clinical outcomes of self-expanding metal stents for treatment of malignant gastroesophageal junction obstructions and prognostic factors for stent patency: Effects of anticancer treatments","volume":"42","author":"Park","year":"2010","journal-title":"Dig. Liver Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1111\/j.1572-0241.2001.03923.x","article-title":"A prospective, randomized, controlled trial of covered expandable metal stents in the palliation of malignant esophageal obstruction at the gastroesophageal junction","volume":"96","author":"Vakil","year":"2001","journal-title":"Am. J. Gastroenterol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1055\/a-0620-8135","article-title":"Fully vs. partially covered selfexpandable metal stent for palliation of malignant esophageal strictures: A randomized trial (the COPAC study)","volume":"50","author":"Didden","year":"2018","journal-title":"Endoscopy"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4025","DOI":"10.1007\/s00464-017-5441-0","article-title":"Fully covered stents are similar to semi-covered stents with regard to migration in palliative treatment of malignant strictures of the esophagus and gastric cardia: Results of a randomized controlled trial","volume":"31","author":"Persson","year":"2017","journal-title":"Surg. Endosc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.gie.2019.01.013","article-title":"A phase III, multicenter, prospective, single-blinded, noninferiority, randomized controlled trial on the performance of a novel esophageal stent with an antireflux valve (with video)","volume":"90","author":"Dua","year":"2019","journal-title":"Gastrointest. Endosc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1055\/s-0033-1344985","article-title":"In vitro evaluation of the radial and axial force of self-expanding esophageal stents","volume":"45","author":"Hirdes","year":"2013","journal-title":"Endoscopy"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1148\/radiol.2472070999","article-title":"Self-expandable esophageal stent loaded with 125I seeds: Initial experience in patients with advanced esophageal cancer","volume":"247","author":"Guo","year":"2008","journal-title":"Radiology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/S1470-2045(14)70131-7","article-title":"Conventional stents versus stents loaded with 125iodine seeds for the treatment of unresectable oesophageal cancer: A multicentre, randomised phase 3 trial","volume":"15","author":"Zhu","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"633","DOI":"10.5114\/wiitm.2021.104205","article-title":"I-125 seed-loaded versus normal stent insertion for obstructive esophageal cancer: A meta-analysis","volume":"16","author":"Zhao","year":"2021","journal-title":"Videosurgery Miniinv."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jconrel.2013.08.010","article-title":"Non-vascular drug eluting stents as localized controlled drug delivery platform: Preclinical and clinical experience","volume":"172","author":"Shaikh","year":"2013","journal-title":"J. Control. Release"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.jconrel.2019.07.001","article-title":"Drug-eluting non-vascular stents for localised drug targeting in obstructive gastrointestinal cancers","volume":"308","author":"Arafat","year":"2019","journal-title":"J. Control. Release"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/j.amjcard.2007.08.016","article-title":"Design Criteria for the Ideal Drug-Eluting Stent","volume":"100","author":"Ako","year":"2007","journal-title":"Am. J. Cardiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1208\/s12249-016-0501-7","article-title":"In Vitro and In Vivo Assessment of Docetaxel Formulation Developed for Esophageal Stents","volume":"18","author":"Shaikh","year":"2017","journal-title":"AAPS PharmSciTech"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.gie.2015.02.034","article-title":"Nitinol stents loaded with a high dose of antitumor 5-fluorouracil or paclitaxel: Esophageal tissue responses in a porcine model","volume":"82","author":"Wang","year":"2015","journal-title":"Gastrointest. Endosc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.biomaterials.2015.03.009","article-title":"Paclitaxel or 5-fluorouracil\/esophageal stent combinations as a novel approach for the treatment of esophageal cancer","volume":"53","author":"Liu","year":"2015","journal-title":"Biomaterials"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3270","DOI":"10.1200\/JCO.1999.17.10.3270","article-title":"Phase II trial of weekly irinotecan plus cisplatin in advanced esophageal cancer","volume":"17","author":"Ilson","year":"1999","journal-title":"J. Clin. Oncol."},{"key":"ref_44","first-page":"316","article-title":"A phase II trial of paclitaxel and cisplatin in patients with advanced carcinoma of the esophagus","volume":"6","author":"Ilson","year":"2000","journal-title":"Cancer J."},{"key":"ref_45","first-page":"CD005048","article-title":"Interventions for dysphagia in oesophageal cancer","volume":"10","author":"Dai","year":"2014","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/S0140-6736(21)01234-4","article-title":"KEYNOTE-590 Investigators. Pembrolizumab plus chemotherapy versus chemotherapy alone for first-line treatment of advanced oesophageal cancer (KEYNOTE-590): A randomised, placebo-controlled, phase 3 study","volume":"398","author":"Sun","year":"2021","journal-title":"Lancet"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1056\/NEJMoa2111380","article-title":"CheckMate 648 Trial Investigators. Nivolumab Combination Therapy in Advanced Esophageal Squamous-Cell Carcinoma","volume":"386","author":"Doki","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/S1470-2045(23)00108-0","article-title":"Tislelizumab plus chemotherapy versus placebo plus chemotherapy as first-line treatment for advanced or metastatic oesophageal squamous cell carcinoma (RATIONALE-306): A global, randomised, placebo-controlled, phase 3 study","volume":"24","author":"Xu","year":"2023","journal-title":"Lancet Oncol."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/30\/7\/447\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:58:19Z","timestamp":1760126299000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/30\/7\/447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,21]]},"references-count":48,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["curroncol30070447"],"URL":"https:\/\/doi.org\/10.3390\/curroncol30070447","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,21]]}}}