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. 2020 Mar 31;11(12):3693-3700.
doi: 10.7150/jca.39033. eCollection 2020.

Risk Factors Associated with Esophageal Fistula after Radiotherapy for Esophageal Squamous Cell Carcinoma

Bing Hu  1   2 , Feng Jia  3 , Haiyan Zhou  4 , Tao Zhou  2 , Qian Zhao  2 , Yiru Chen  2 , Baosheng Li  2 , Wei Huang  2
Affiliations

Risk Factors Associated with Esophageal Fistula after Radiotherapy for Esophageal Squamous Cell Carcinoma

Bing Hu et al. J Cancer. .

Abstract

Purpose: The aim of this study was to investigate risk factors for esophageal squamous cell carcinoma (ESCC) treated with radiotherapy (RT) with or without chemotherapy to guide how to reduce the occurrence of esophageal fistula (EF). Methods: 414 patients with ESCC who underwent RT with or without chemotherapy were collected in Shandong Cancer Hospital from February 2012 to June 2018 retrospectively. The clinical characters and dosimetric parameters were recorded. Univariate and multivariate logistic regression analyses were provided to determine the risk factors associated with EF. Results: The cumulative incidences of EF were 11.1% (46/414 patients). The median follow-up period was 15.8 months (range: 0.2-82.6months). The median survival time (MST) of patients with EF was 5.3 months. In univariate analysis, age, T4 stage, N3 stage, chemotherapy regimens, re-RT, ulcerative esophageal cancer (EC), esophageal stenosis, the maximum thickness of the tumor and the length of tumor had a correlation with the prevalence of EF. In multivariable logistic regression analysis, T4 stage, N3 stage, re-RT, ulcerative EC, esophageal stenosis, the maximum thickness of the tumor was confirmed as risk factors for EF. Conclusion: This study revealed that T4 stage, N3 stage, re-RT, ulcerative EC, esophageal stenosis, the maximum thickness of the tumor were risk factors associated with EF. We ought to attach importance to the prevention of EF. Patients with risk factors for EF should be paid close attention.

Keywords: esophageal fistula; esophageal squamous cell carcinoma; radiotherapy; risk factor; side effect.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Axial contrast-enhanced computed tomographic (CT) scan of the chest shows esophagorespiratory fistula.
Figure 2
Figure 2
Barium esophagography shows esophageal-mediastinum fistula.
Figure 3
Figure 3
Survival functions between esophagus fistual and no-esophagus fistual.
Figure 4
Figure 4
Survival functions between esophagorespiratory fistula and esophageal-mediastinum fistula.
See this image and copyright information in PMC

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