Esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal squamous cell carcinoma.

<h4>Background</h4>The literature regarding esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy (IMRT) for esophageal squamous cell carcinoma (ESCC) remains lacking. We aimed to investigate the risk factors of esophageal fistula among ESCC pat...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Tzu-Hui Pao, Ying-Yuan Chen, Wei-Lun Chang, Jeffrey Shu-Ming Chang, Nai-Jung Chiang, Chia-Ying Lin, Wu-Wei Lai, Yau-Lin Tseng, Yi-Ting Yen, Ta-Jung Chung, Forn-Chia Lin
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/990aabbf66e548fc95f1ed140b659171
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:990aabbf66e548fc95f1ed140b659171
record_format	dspace
spelling	oai:doaj.org-article:990aabbf66e548fc95f1ed140b6591712021-11-25T06:19:13ZEsophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal squamous cell carcinoma.1932-620310.1371/journal.pone.0251811https://doaj.org/article/990aabbf66e548fc95f1ed140b6591712021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251811https://doaj.org/toc/1932-6203<h4>Background</h4>The literature regarding esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy (IMRT) for esophageal squamous cell carcinoma (ESCC) remains lacking. We aimed to investigate the risk factors of esophageal fistula among ESCC patients undergoing definitive concurrent chemoradiotherapy (CCRT) via IMRT technique.<h4>Methods</h4>A total of 129 consecutive ESCC patients receiving definitive CCRT with IMRT between 2008 and 2018 were reviewed. The cumulative incidence of esophageal fistula and survival of patients were estimated by the Kaplan-Meier method and compared between groups by the log-rank test. The risk factors of esophageal fistula were determined with multivariate Cox proportional hazards regression analysis.<h4>Results</h4>Median follow-up was 14.9 months (IQR, 7.0-28.8). Esophageal perforation was identified in 20 (15.5%) patients, resulting in esophago-pleural fistula in nine, esophago-tracheal fistula in seven, broncho-esophageal fistula in two, and aorto-esophageal fistula in two patients. The median interval from IMRT to the occurrence of esophageal fistula was 4.4 months (IQR, 3.3-10.1). Patients with esophageal fistula had an inferior median overall survival (10.0 vs. 17.2 months, p = 0.0096). T4 (HR, 3.776; 95% CI, 1.383-10.308; p = 0.010) and esophageal stenosis (HR, 2.601; 95% CI, 1.053-6.428; p = 0.038) at baseline were the independent risk factors for esophageal fistula. The cumulative incidence of esophageal fistula was higher in patients with T4 (p = 0.018) and pre-treatment esophageal stenosis (p = 0.045). There was a trend toward better survival after esophageal fistula among patients receiving repair or stenting for the fistula than those only undergoing conservative treatments (median survival, 5.9 vs. 0.9 months, p = 0.058).<h4>Conclusions</h4>T4 and esophageal stenosis at baseline independently increased the risk of esophageal fistula in ESCC treated by definitive CCRT with IMRT. There existed a trend toward improved survival after the fistula among patients receiving repair or stenting for esophageal perforation.Tzu-Hui PaoYing-Yuan ChenWei-Lun ChangJeffrey Shu-Ming ChangNai-Jung ChiangChia-Ying LinWu-Wei LaiYau-Lin TsengYi-Ting YenTa-Jung ChungForn-Chia LinPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251811 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tzu-Hui Pao Ying-Yuan Chen Wei-Lun Chang Jeffrey Shu-Ming Chang Nai-Jung Chiang Chia-Ying Lin Wu-Wei Lai Yau-Lin Tseng Yi-Ting Yen Ta-Jung Chung Forn-Chia Lin Esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal squamous cell carcinoma.
description	<h4>Background</h4>The literature regarding esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy (IMRT) for esophageal squamous cell carcinoma (ESCC) remains lacking. We aimed to investigate the risk factors of esophageal fistula among ESCC patients undergoing definitive concurrent chemoradiotherapy (CCRT) via IMRT technique.<h4>Methods</h4>A total of 129 consecutive ESCC patients receiving definitive CCRT with IMRT between 2008 and 2018 were reviewed. The cumulative incidence of esophageal fistula and survival of patients were estimated by the Kaplan-Meier method and compared between groups by the log-rank test. The risk factors of esophageal fistula were determined with multivariate Cox proportional hazards regression analysis.<h4>Results</h4>Median follow-up was 14.9 months (IQR, 7.0-28.8). Esophageal perforation was identified in 20 (15.5%) patients, resulting in esophago-pleural fistula in nine, esophago-tracheal fistula in seven, broncho-esophageal fistula in two, and aorto-esophageal fistula in two patients. The median interval from IMRT to the occurrence of esophageal fistula was 4.4 months (IQR, 3.3-10.1). Patients with esophageal fistula had an inferior median overall survival (10.0 vs. 17.2 months, p = 0.0096). T4 (HR, 3.776; 95% CI, 1.383-10.308; p = 0.010) and esophageal stenosis (HR, 2.601; 95% CI, 1.053-6.428; p = 0.038) at baseline were the independent risk factors for esophageal fistula. The cumulative incidence of esophageal fistula was higher in patients with T4 (p = 0.018) and pre-treatment esophageal stenosis (p = 0.045). There was a trend toward better survival after esophageal fistula among patients receiving repair or stenting for the fistula than those only undergoing conservative treatments (median survival, 5.9 vs. 0.9 months, p = 0.058).<h4>Conclusions</h4>T4 and esophageal stenosis at baseline independently increased the risk of esophageal fistula in ESCC treated by definitive CCRT with IMRT. There existed a trend toward improved survival after the fistula among patients receiving repair or stenting for esophageal perforation.
format	article
author	Tzu-Hui Pao Ying-Yuan Chen Wei-Lun Chang Jeffrey Shu-Ming Chang Nai-Jung Chiang Chia-Ying Lin Wu-Wei Lai Yau-Lin Tseng Yi-Ting Yen Ta-Jung Chung Forn-Chia Lin
author_facet	Tzu-Hui Pao Ying-Yuan Chen Wei-Lun Chang Jeffrey Shu-Ming Chang Nai-Jung Chiang Chia-Ying Lin Wu-Wei Lai Yau-Lin Tseng Yi-Ting Yen Ta-Jung Chung Forn-Chia Lin
author_sort	Tzu-Hui Pao
title	Esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal squamous cell carcinoma.
title_short	Esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal squamous cell carcinoma.
title_full	Esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal squamous cell carcinoma.
title_fullStr	Esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal squamous cell carcinoma.
title_full_unstemmed	Esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal squamous cell carcinoma.
title_sort	esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal squamous cell carcinoma.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/990aabbf66e548fc95f1ed140b659171
work_keys_str_mv	AT tzuhuipao esophagealfistulaafterdefinitiveconcurrentchemotherapyandintensitymodulatedradiotherapyforesophagealsquamouscellcarcinoma AT yingyuanchen esophagealfistulaafterdefinitiveconcurrentchemotherapyandintensitymodulatedradiotherapyforesophagealsquamouscellcarcinoma AT weilunchang esophagealfistulaafterdefinitiveconcurrentchemotherapyandintensitymodulatedradiotherapyforesophagealsquamouscellcarcinoma AT jeffreyshumingchang esophagealfistulaafterdefinitiveconcurrentchemotherapyandintensitymodulatedradiotherapyforesophagealsquamouscellcarcinoma AT naijungchiang esophagealfistulaafterdefinitiveconcurrentchemotherapyandintensitymodulatedradiotherapyforesophagealsquamouscellcarcinoma AT chiayinglin esophagealfistulaafterdefinitiveconcurrentchemotherapyandintensitymodulatedradiotherapyforesophagealsquamouscellcarcinoma AT wuweilai esophagealfistulaafterdefinitiveconcurrentchemotherapyandintensitymodulatedradiotherapyforesophagealsquamouscellcarcinoma AT yaulintseng esophagealfistulaafterdefinitiveconcurrentchemotherapyandintensitymodulatedradiotherapyforesophagealsquamouscellcarcinoma AT yitingyen esophagealfistulaafterdefinitiveconcurrentchemotherapyandintensitymodulatedradiotherapyforesophagealsquamouscellcarcinoma AT tajungchung esophagealfistulaafterdefinitiveconcurrentchemotherapyandintensitymodulatedradiotherapyforesophagealsquamouscellcarcinoma AT fornchialin esophagealfistulaafterdefinitiveconcurrentchemotherapyandintensitymodulatedradiotherapyforesophagealsquamouscellcarcinoma
_version_	1718413939636699136

Esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal squamous cell carcinoma.

Ejemplares similares