Abstract: Objective: To explore the value of stent placement plus radiation therapy for advanced esophageal cancer. Methods: On the second day after conventional esophageal stent placement, 6w linear gas pedal irradiation was used with 180-200 CGR per day, 5 days per week for 5-6 weeks. Results: The success rate of stent placement was 100%, the six-month survival rate was 96.4%, the one-year survival rate was 83.9%, the two-year survival rate was 39.3%, and the feeding status of all patients was improved by more than two levels. All patients with neck metastases disappeared after radiotherapy. Conclusion: Stent placement and radiation therapy for advanced esophageal cancer is a safe and effective treatment method. Stenting is an effective palliative treatment for advanced esophageal cancer with high stenosis without surgical indication. However, stenting alone cannot fundamentally solve the problem of cancer cell infiltration and growth, and without timely follow-up radiotherapy or chemotherapy, it can only temporarily solve the patient’s dysphagia and improve the quality of life, but cannot prolong the survival period. From March 2003 to January 2006, endoscopic stent placement and combined radiation therapy for 56 patients with advanced esophageal cancer achieved satisfactory results, which are now reported as follows: 1 Data and Methods 1.1 General data: 56 patients in this group, 40 men and 16 women aged 38-81 years old, average age 63 years old. The patients were selected by the Department of Gastroenterology and the Department of Radiotherapy of our hospital for advanced esophageal cancer, with expected survival of no more than three months, and the length of the lesion was 6~10 cm.The patients complained of dysphagia as the main complaint, and according to the degree of dysphagia, the patients were classified by the Stooler grading: 19 cases of grade IV, 34 cases of grade III, and 3 cases of grade II. All patients were diagnosed with squamous carcinoma by endoscopy and cytology, and 11 cases had cervical lymph node metastasis, with the smallest metastatic foci of 0.5 cm and the largest of 4 cm. 1.2 Instruments: Fuji e-gastroscope, guiding wires, conical silicone dilatation probes (produced by COOK, USA, with diameters ranging from 0.5 cm to 1.5 cm), nickel-titanium memory alloy stents (made in China, with the specifications of the stents of the present group being inner diameter of 2.0 cm and length of 8 c m to 12 c m), nickel-titanium memory alloy stent (made in China, with the specifications of the stents of the present group being inner diameter of 2.0 cm and length of 8 c m). The specification of the stent in this group is 2.0 cm inner diameter, 8 ~ 12 c m length), stent placement device. 1.3 Placement method: preoperative intramuscular injection of dulcolax and atropine, local anesthesia of the pharynx under direct endoscopic observation of the stenosis site, along the biopsy hole inserted into the guiding wire across the stenosis to the gastric lumen, through the guiding wire inserted into the conical silicone expansion probe from small to large in turn to expand to 1.2 ~ 1.5 cm or so, the inner diameter of the stenosis through the stenosis, the length of the stenosis is accurately measured under direct vision, the selection of the stent, stent needs to exceed the tumor at least 2 cm at both ends of the stent [1]. The stent should exceed the tumor by at least 2 cm at both ends [1]. Put a clear mark on the upper port of the stent insertion device, send the stent insertion device into the stenosis site through the guidewire under X-ray monitoring, so that the stenosis is completely opened and the cancerous lesion is completely covered, withdraw the insertion device, insert the gastroscope, observe whether the position of the stent is appropriate or not, and then adjust the stent position under the microscope if necessary. 1.4 Radiation therapy: the day after esophageal stent placement, 6w linear gas pedal irradiation was used, with reference to X-ray and endoscopy results, positioned under the analog positioning machine, the irradiation width was 6-7cm, the length of the cancerous foci was 3cm above and below the cancerous foci, irradiation was performed for 5 days per week, 180-200CGr per day for 5-6 weeks, and radical irradiation was routinely performed for patients with metastatic foci in the neck. 2 Results: In 56 patients in this group, the stent was successfully placed at one time, with a success rate of 100%. After stent placement, the stenosis was significantly expanded, and the dysphagia was significantly improved, of which 36 cases were fed with ordinary food, 16 cases were fed with soft food, and 4 cases were fed with semi-liquid diet. Complications: (1) Stent migration: 3 patients had dysphagia again 3 weeks after the operation, and gastroscopy showed that the stent had moved upward (due to acute gastrointestinal vomiting), and the symptoms disappeared after endoscopic repositioning. (2) Chest pain: most of the patients had different degrees of retrosternal or epigastric pain after tube placement or during radiation therapy, and 7 of them had pain for as long as one month, which was relieved by antibiotics, antacids and symptomatic treatment. Follow-up: 2 elderly patients died of acute left heart failure and extensive cancer metastasis in 1.2~2.0 months after the operation and suffered from systemic failure, while the other patients were able to survive by mouth, with a survival rate of 96.4% in six months, 83.9% in one year, and 39.3% in two years, and the feeding status of all patients was improved by two grades or more. All patients with metastases in neck disappeared after radiotherapy. 3 DISCUSSION Esophageal cancer intubation used to be performed by surgery in the past, which had a narrower scope of application (large surgical blow, high postoperative complications and mortality) [2]. Endoscopic stent placement for advanced esophageal cancer without surgical indication is a safe and effective palliative treatment. Nickel-titanium memory alloy stents have unique shape memory properties, good biocompatibility, high reproducibility and strong support, especially the stent with membrane, which can keep the stenosis open for a long time and prevent cancer cells from growing inward [3]. Therefore, all patients in this group used membrane esophageal stents. In the subsequent radiation therapy, the memory alloy stent cannot pass through the radiation and has the role of internal localization [4]. Simple stenting for patients with advanced esophageal cancer and high stenosis cannot fundamentally solve the problem of cancer cell infiltration and growth, and without timely follow-up radiotherapy or chemotherapy, it can only temporarily solve the patient’s dysphagia and improve the quality of life, but cannot prolong the survival period. After esophageal stenting in this group of patients, the problem of feeding difficulty was obviously improved, nutritional intake was increased, and the patient’s confidence in treatment was improved. Meanwhile, radiotherapy was performed, which not only made the tumor effectively treated, but also obviously improved the patient’s quality of life and prolonged the patient’s survival period. After the treatment, the six-month survival rate of 96.4%, one-year survival rate of 83.9%, and two-year survival rate of 39.3% were achieved. Therefore, it is considered that stenting plus radiotherapy has more obvious effect than single stenting or radiotherapy, and it is a safe and effective treatment method for advanced esophageal cancer.