Chan-Jun Zhen, Wen-Wen Bai, Ping Zhang, Yu-Zhi Song, Ya-Jing Wang, Xue-Ying Qiao, Zhi-Guo Zhou
Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Hebei, Shijiazhuang, China.
Front Oncol. 2023 Jan 12;12:961902. doi: 10.3389/fonc.2022.961902. eCollection 2022.
Retrospectively analyzed the esophageal carcinoma (EC) patients with esophageal perforation (EP) after radiotherapy to discuss the treatment and prognosis.
Data of patients with EC who had EP after radiotherapy in Hebei Cancer Hospital were collected from 2001 to 2020 and retrospectively analyzed. All analyses were performed using SPSS Statistics for Windows, version 18. 0 (SPSS Inc., Chicago, Ill., USA). values less than 0.05 were considered statistically significant.
A total of 94 patients with EC were enrolled, among which 72 were males and 22 were females, with a median age of 62 (38-82) years. The tumor was located in the upper thoracic in 45 patients, middle thoracic in 45 patients, and lower thoracic in 4 patients. There were 30 cases of tracheoesophageal fistula (TEF) and 64 cases of esophagomediastinal fistula (EMF). All patients died within 11 months (median: two months) after EP. After EP, 48 patients were treated by tube feeding (include nasal feeding and gastrostomy), 26 patients by esophageal stenting, and 20 patients by fluid infusion therapy, and their one, three, and six months survival rates after EP were 81.3%, 31.3%, and 12.5% (P = 0.000). In the TEF group, the one, three, and six month survival rates after EP of tube feeding, esophageal stenting and fluid infusion groups were 88.2%, 17.6%, 11.8%; 45.5%, 27.3%, 0%; and 50.0%, 50.0%, 0% ( = 0.345). In the EMF group, the one, three, and six months survival rates after EP of this three groups were 77.4%, 38.7%, 12.9%; 26.7%, 20.0%, 6.7%; and 22.2%, 11.1%, 0% (=0.002), respectively.
Most patients with EP after radiotherapy died within six months, with low survival and poor prognosis. Tube feeding therapy can achieve relatively good survival, especially for patients with EMF. The survival of patients treated by tube feeding therapy is significantly better than the survival of those treated by other methods.
回顾性分析食管癌（EC）患者放疗后发生食管穿孔（EP）的情况，以探讨其治疗方法及预后。
收集2001年至2020年在河北医科大学第四医院放疗后发生EP的EC患者资料，并进行回顾性分析。所有分析均使用SPSS Statistics for Windows 18.0版软件（SPSS公司，美国伊利诺伊州芝加哥）。P值小于0.05被认为具有统计学意义。
共纳入94例EC患者，其中男性72例，女性22例，中位年龄62（38 - 82）岁。肿瘤位于胸上段45例，胸中段45例，胸下段4例。发生气管食管瘘（TEF）30例，食管纵隔瘘（EMF）64例。所有患者在发生EP后11个月内（中位时间：2个月）死亡。EP发生后，48例患者接受管饲（包括鼻饲和胃造瘘）治疗，26例患者接受食管支架置入治疗，20例患者接受输液治疗，EP后1个月、3个月和6个月的生存率分别为81.3%、31.3%和12.5%（P = 0.000）。在TEF组中，管饲、食管支架置入和输液组EP后1个月、3个月和6个月的生存率分别为88.2%、17.6%、11.8%；45.5%、27.3%、0%；50.0%、50.0%、0%（P = 0.345）。在EMF组中，这三组EP后1个月、3个月和6个月的生存率分别为77.4%、38.7%、12.9%；26.7%、20.0%、6.7%；22.2%、11.1%、0%（P = 0.002）。
大多数放疗后发生EP的患者在6个月内死亡，生存率低，预后差。管饲治疗可获得相对较好的生存率，尤其是对于EMF患者。管饲治疗患者的生存率明显优于其他治疗方法患者的生存率。
