Izumi Atsuko, Yoshio Toshiyuki, Sasaki Takashi, Ishioka Mitsuaki, Kizawa Atsuko, Ikenoyama Yohei, Namikawa Ken, Tokai Yoshitaka, Yoshimizu Shoichi, Horiuchi Yusuke, Ishiyama Akiyoshi, Hirasawa Toshiaki, Chin Keisho, Ogura Mariko, Sasahira Naoki, Fujisaki Junko
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
J Clin Med. 2023 Sep 8;12(18):5859. doi: 10.3390/jcm12185859.
Patients with malignant esophageal fistulas often experience dysphagia and infection, resulting in poor prognoses. Self-expandable metallic stent (SEMS) placement is a palliative treatment option; however, its efficacy and safety are unclear. We aimed to determine the efficacy and safety of SEMS placement for malignant esophageal fistulas. We retrospectively investigated patients who underwent SEMS placement for malignant esophageal fistulas between 2013 and 2022 at the Cancer Institute Hospital. Dysphagia scores (DSs) before and after SEMS placement, adverse events, and overall survival from SEMS placement until death were evaluated. A total of 17 patients underwent SEMS placement, including 12 and 5 patients with esophageal and lung cancers, respectively. Prior treatments included chemoradiotherapy ( = 11), radiotherapy ( = 4), and chemotherapy ( = 4); two patients underwent palliative radiotherapy after chemotherapy. All procedures were technically successful. After SEMS placement, 14 (82.4%) patients were able to consume semisolid or solid food (DS ≤ 2). Major adverse events were encountered in only one case. The median survival time after SEMS placement was 71 days (range 17-247 days). SEMS placement allowed most patients to resume oral intake with a low rate of major adverse events. SEMS placement is a reasonable palliative treatment option for patients with malignant fistulas who have poor prognoses.
恶性食管瘘患者常出现吞咽困难和感染，导致预后不良。自膨式金属支架（SEMS）置入是一种姑息治疗选择；然而，其疗效和安全性尚不清楚。我们旨在确定SEMS置入治疗恶性食管瘘的疗效和安全性。我们回顾性研究了2013年至2022年期间在癌症研究所医院接受SEMS置入治疗恶性食管瘘的患者。评估了SEMS置入前后的吞咽困难评分（DSs）、不良事件以及从SEMS置入至死亡的总生存期。共有17例患者接受了SEMS置入，其中分别有12例和5例患有食管癌和肺癌。先前的治疗包括放化疗（n = 11）、放疗（n = 4）和化疗（n = 4）；2例患者在化疗后接受了姑息性放疗。所有手术在技术上均获成功。SEMS置入后，14例（82.4%）患者能够进食半固体或固体食物（DS≤2）。仅1例出现严重不良事件。SEMS置入后的中位生存时间为71天（范围17 - 247天）。SEMS置入使大多数患者能够恢复经口进食，且严重不良事件发生率较低。对于预后不良的恶性瘘患者，SEMS置入是一种合理的姑息治疗选择。
