A Review of the Use of Stents for Palliation of Esophageal and Lung Cancer

According to the American Cancer Society, there will be an estimated 14,520 new cases of esophageal cancer and 174,470 new cases of lung cancer in 2005 [1]. Close to 60% of these patients with esophageal cancer will present at an advanced stage not amenable to cure, but still will require palliation of their dysphagia [2]. Conventional plastic stents (CPS) were used initially, and with continuous improvement in technology, insertion of selfexpanding metal stents (SEMS) has become the palliative treatment of choice in the majority of these patients [3-7]. SEMS are effective in palliating malignant dysphagia in 85%-100% of patients [7-9]. More recently, a new selfexpanding plastic stent (SEPS) has been designed which in early studies has been very effective in palliating dysphagia [10-13]. Similarly, the majority of patients with lung cancer will present at an advanced stage and approximately 20% of these patients will have an endobronchial component requiring some form of palliation for relief of airway obstruction [14]. Currently airway stents are either made of self-expanding metal for more permanent use, or silicone if a more temporary solution is needed. Complications similar to the esophageal stents may arise. The purpose of this article is to provide an evidence based review of stents in the palliative setting for esophageal and lung cancer and briefly explore their potential use and expanding indications in the neoadjuvant setting.