Background Dysphagia is the most common symptom in advanced esophageal cancer patients. Esophageal stent placement (SP) is a common palliation method but can be associated with significant morbidity. Limited data exist regarding the ability of spray cryotherapy (SC) prolong time to SP. Methods A Mayo Clinic (Rochester, MN) patient database was reviewed for cases with a SC indication of esophageal cancer palliation from 2007–2019. Procedures were performed using a liquid nitrogen SC system to apply 2–5 separate 20 second freeze and 60 second thaw cycles based on tumor characteristics. Primary outcome was time to subsequent palliative SP. Results Of 56 patients (71.4% male, mean age 77.8 ± 10.2 years) who underwent a total of 199 SC sessions (mean 3.6 ± 2.7, range 1–12 per patient), 41 had adenocarcinoma and 15 squamous cell carcinoma (SCC). Overall, 13 patients underwent subsequent SP within a mean duration of 15.7 ± 11.0 months over a mean follow-up duration of 25.6 ± 29.4 months. Treatment did produce stenosis in 16 patients, who required dilation within a mean period of 193.1 ± 294.1 days; notably, 10 patients had a history of preceding malignant strictures requiring dilation. Two patients experienced bleeding requiring transfusion, whereas 1 experienced perforation at the start of SC. Prior chemotherapy and/or radiation was not associated with developing an SC-related complication (risk ratio (RR) 1.5; 95% CI 0.6–3.7, P > 0.4). Conclusions SC appears to be an effective and safe modality to palliate esophageal cancer in appropriate candidates. Majority of patients who undergo SC avoid the need for future SP. If patients eventually require SP, they are able to, on average, defer stenting for >1 year from SC initiation.

中文翻译：

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喷雾冷冻疗法可防止食管癌相关吞咽困难患者对姑息性支架置入术的需要

背景吞咽困难是晚期食管癌患者最常见的症状。食管支架置入 (SP) 是一种常见的姑息治疗方法，但可能与显着的发病率有关。关于喷雾冷冻疗法 (SC) 延长 SP 时间的能力的数据有限。方法 对 Mayo Clinic（明尼苏达州罗切斯特）患者数据库进行审查，以查找 2007 年至 2019 年期间具有食管癌姑息性 SC 适应症的病例。使用液氮 SC 系统执行程序，根据肿瘤特征应用 2-5 个单独的 20 秒冷冻和 60 秒解冻循环。主要结果是到随后的姑息性 SP 的时间。结果 56 名患者（71.4% 男性，平均年龄 77.8 ± 10.2 岁）共接受了 199 次 SC 疗程（平均 3.6 ± 2.7，范围为每名患者 1-12 次），其中 41 名患有腺癌，15 名患有鳞状细胞癌 (SCC)。全面的，13 名患者在平均 15.7 ± 11.0 个月的平均随访时间内接受了随后的 SP，平均随访时间为 25.6 ± 29.4 个月。治疗确实在 16 名患者中产生了狭窄，他们需要在平均 193.1 ± 294.1 天的时间内进行扩张；值得注意的是，10 名患者既往有需要扩张的恶性狭窄病史。两名患者出现需要输血的出血，而 1 名患者在 SC 开始时出现穿孔。既往化疗和/或放疗与发生 SC 相关并发症无关（风险比 (RR) 1.5；95% CI 0.6-3.7，P > 0.4）。结论 SC 似乎是一种有效且安全的方式来缓解适当候选人的食管癌。大多数接受 SC 的患者避免了未来 SP 的需要。如果患者最终需要 SP，他们平均能够