Honda Takayuki, Tsuzaki Yoshihito, Mitaka Keiko, Fukasawa Kazuhiro, Miyashita Yoshihiro, Marino Kan, Saito Akitoshi, Oyama Toshio, Inase Naohiko
Department of Respiratory Medicine, Kofu, Tokyo Medical and Dental University, Tokyo, Japan.
Case Rep Oncol. 2011;4(2):350-7. doi: 10.1159/000330368. Epub 2011 Jul 9.
A 45-year-old man complaining of cough, dyspnea, and difficulty in swallowing was referred to our hospital. Chest CT scan showed a mediastinal mass compressing the trachea. He was diagnosed with poorly differentiated lung carcinoma by percutaneous needle biopsy. Bronchoscopy and upper gastrointestinal endoscopy revealed a tracheoesophageal fistula (TEF). Long-lasting febrile neutropenia made it impossible to continue chemotherapy, but a course of radiotherapy (total 61 Gy) was completed. The next endoscopy revealed closure of the TEF. Chemoradiotherapy (CRT) has been reported to close TEF in esophageal cancer, but the risk of a CRT-induced worsening of the fistula has dissuaded physicians from using CRT to treat TEF in lung cancer patients. CRT may serve as a palliative treatment for TEF in lung cancer as well as esophageal cancer.
一名45岁男性因咳嗽、呼吸困难和吞咽困难前来我院就诊。胸部CT扫描显示纵隔肿物压迫气管。经皮针吸活检诊断为低分化肺癌。支气管镜检查和上消化道内镜检查发现气管食管瘘（TEF）。长期发热性中性粒细胞减少症使化疗无法继续进行，但完成了一个疗程的放疗（总计61 Gy）。下次内镜检查显示TEF闭合。据报道，放化疗（CRT）可使食管癌的TEF闭合，但CRT导致瘘管恶化的风险使医生不愿用CRT治疗肺癌患者的TEF。CRT可作为肺癌和食管癌TEF的姑息治疗方法。
