Palliation of dysphagia in patients with unresectable oesophageal tumours—current methods and indications—a review

: Dysphagia is a common symptom in patients with unresectable esophageal cancer or metastatic disease. It is a debilitating symptom compromising biological status and quality of life. This article is intended to be an analysis of the various methods currently used in the treatment of dysphagia in patients with unresectable esophageal cancer, in terms of selecting the optimal procedure for each patient. The introduction of endoscopic stenting has been a huge step forward for patients with unresectable tumors, but this indication needs to be adapted according to several criteria. Choosing the optimal stent is currently a challenge given the technical progress in this area. Palliative brachytherapy is the most effective method of improving dysphagia through a higher control of the local evolution of the disease, its indication is supported by the results of several studies. The endoscopic ablative methods currently used have promising results, but have frequently shown a transient effect on dysphagia, requiring several sessions or an association with another landing method. A recent approach is the use of combined palliation methods, which offer the benefits of each method to achieve the best and long-term efficiency for the relief of dysphagia. The selection of the optimal method to alleviate dysphagia in patients with unrecognized malignancies remains a topic of discussion.