Huang Xiaoyan, He Xiaojian, Chen Xi, Li Yuande
Xiaoyan Huang, MM, is Doctor at Department of Medical Oncology, The 900TH Hospital of Joint Logistics Support Force, Fujian Medical University, and Affiliated Dongfang Hospital, Xiamen University School of Medicine, and Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China.
Xiaojian He, MM, is Doctor at Department of Gastroenterology, The 900TH Hospital of Joint Logistics Support Force, Fuzhou, Fujian Province, China.
Gastroenterol Nurs. 2024;47(5):331-337. doi: 10.1097/SGA.0000000000000794. Epub 2024 Sep 27.
Surgical resection is the preferred treatment for early-stage esophageal cancer. But most patients with esophageal cancer are diagnosed at advanced stages, making them ineligible for surgery. Therefore, preoperative neoadjuvant therapy has been introduced to help them meet surgical requirements. However, this therapy has been associated with serious complications, such as diarrhea, preventing patients from surgery. During neoadjuvant therapy combined with chemoradiotherapy, a 58-year-old male patient with esophageal cancer was diagnosed with severe immune-related colitis, which seriously affected both cancer treatment and the patient's quality of life. Despite conventional antidiarrheal therapy, the patient remained refractory to treatment. However, after undergoing fecal microbiota transplantation, the frequency of diarrhea was significantly reduced. During e-colonoscopy, no significant ulcers were found in the sigmoid colon. Additionally, successful radical resection of esophageal cancer was performed, resulting in a favorable outcome for the patient. Regular follow-up appointments were scheduled to monitor the patient's progress. Fecal microbiota transplantation effectively relieved severe immune-related diarrhea in a patient undergoing neoadjuvant immunotherapy and chemoradiotherapy for esophageal cancer. This successful treatment ultimately enabled the patient to meet the surgical requirements for radical esophagectomy.
手术切除是早期食管癌的首选治疗方法。但大多数食管癌患者在晚期才被诊断出来，这使得他们不适合进行手术。因此，术前新辅助治疗被引入以帮助他们满足手术要求。然而，这种治疗与严重并发症有关，如腹泻，从而妨碍患者进行手术。在新辅助放化疗期间，一名58岁的男性食管癌患者被诊断出患有严重的免疫相关性结肠炎，这严重影响了癌症治疗和患者的生活质量。尽管采用了传统的止泻治疗，但该患者对治疗仍无反应。然而，在接受粪便微生物群移植后，腹泻频率显著降低。在电子结肠镜检查中，乙状结肠未发现明显溃疡。此外，成功进行了食管癌根治性切除，患者预后良好。安排了定期随访以监测患者的进展。粪便微生物群移植有效缓解了一名接受食管癌新辅助免疫治疗和放化疗患者的严重免疫相关性腹泻。这种成功的治疗最终使患者满足了根治性食管切除术的手术要求。
