Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, No. 59, Shengli Rd, Xiangcheng District, Zhangzhou, 363000, Fujian, People's Republic of China.
Department of Intensive Care Unit, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Twelve Bridges Rd, Jinniu District, Chengdu, 610075, Sichuan, People's Republic of China.
Sci Rep. 2024 Jul 26;14(1):17144. doi: 10.1038/s41598-024-67859-0.
Limited studies have focused on the prognostic factors of esophageal respiratory fistula (ERF) associated with radiotherapy in patients with unresectable esophageal squamous cell carcinoma (ESCC). Between January 1st, 2014 and January 1st, 2021, we included patients who were initially diagnosed with unresectable ESCC and underwent radiotherapy. All patients were followed up for a period of 2 years after completing their radiotherapy treatment. The primary outcomes of the study were defined as death or severe adverse events. The survival curves of ERF were calculated using the Kaplan-Meier method. Cox proportional hazards model was employed to calculated the prognostic factors. A cohort of 232 patients underwent radiotherapy, of whom 32 patients experienced ERF. The median period from initial diagnosis of ESCC to ERF was 5.75 months, and the median period from ERF to the primary outcome was 4.6 weeks. Neck + upper chest location (odds ratio [OR] 3.305), high T stage (OR 1.765), esophageal stenosis (OR 1.073), high neutrophil to lymphocyte ratio (NLR) (OR 1.384) and platelet to lymphocyte ratio (PLR) (OR 1.765) were risk factors for the occurrence of ERF. Cox regression analysis suggested that tumor location (hazards ratio [HR] 3.572, 95% confidence interval [CI] 2.467-5.1), high T stage (HR 4.050, 95% CI 2.812-5.831), esophageal stenosis (HR 2.643, 95% CI 1.753-3.983), high PLR (HR 2.541, 95% CI 1.868-3.177) were independent prognostic factors for poor survival. Esophageal stenosis, neck + upper chest tumor location, high T stage and PLR predicted the prognosis of ERF in ESCC patients undergoing radiotherapy.
有限的研究集中在与不可切除的食管鳞状细胞癌（ESCC）患者放疗相关的食管呼吸瘘（ERF）的预后因素上。2014 年 1 月 1 日至 2021 年 1 月 1 日期间，我们纳入了最初诊断为不可切除的 ESCC 并接受放疗的患者。所有患者在完成放疗治疗后随访 2 年。该研究的主要结局定义为死亡或严重不良事件。使用 Kaplan-Meier 法计算 ERF 的生存曲线。Cox 比例风险模型用于计算预后因素。一组 232 例患者接受了放疗，其中 32 例发生了 ERF。从 ESCC 初始诊断到 ERF 的中位时间为 5.75 个月，从 ERF 到主要结局的中位时间为 4.6 周。颈部+上胸部位置（比值比[OR]3.305）、高 T 期（OR 1.765）、食管狭窄（OR 1.073）、高中性粒细胞与淋巴细胞比值（NLR）（OR 1.384）和血小板与淋巴细胞比值（PLR）（OR 1.765）是 ERF 发生的危险因素。Cox 回归分析表明，肿瘤位置（风险比[HR]3.572，95%置信区间[CI]2.467-5.1）、高 T 期（HR 4.050，95%CI 2.812-5.831）、食管狭窄（HR 2.643，95%CI 1.753-3.983）、高 PLR（HR 2.541，95%CI 1.868-3.177）是放疗后 ESCC 患者不良生存的独立预后因素。食管狭窄、颈部+上胸部肿瘤位置、高 T 期和 PLR 预测了 ESCC 患者放疗后 ERF 的预后。
