医学
食管癌
瘘管
四分位间距
放化疗
内科学
单变量分析
风险因素
优势比
胃肠病学
放射科
外科
放射治疗
癌症
多元分析
作者
Takahiro Tsushima,Junki Mizusawa,Kazuki Sudo,Yoshitaka Honma,Ken Kato,Hiroyasu Igaki,Yasuhiro Tsubosa,Masayuki Sekiguchi,Kenichi Nakamura,Haruhiko Fukuda,Yuko Kitagawa
出处
期刊:Medicine
[Ovid Technologies (Wolters Kluwer)]
日期:2016-05-01
卷期号:95 (20): e3699-e3699
被引量:57
标识
DOI:10.1097/md.0000000000003699
摘要
Esophageal fistula is a critical adverse event in patients treated with chemoradiotherapy (CRT) for locally advanced esophageal cancer. However, risk factors associated with esophageal fistula formation in patients receiving CRT have not yet been elucidated. We retrospectively analyzed data obtained from 140 patients who were enrolled in a phase II/III trial comparing low-dose cisplatin with standard-dose cisplatin administered in combination with 5-flurouracil and concomitant radiotherapy. Inclusion criteria were performance status (PS) 0 to 2 and histologically proven thoracic esophageal cancer clinically diagnosed as T4 and/or unresectable lymph node metastasis for which definitive CRT was applicable. Risk factors for esophageal fistula were examined with univariate analysis using Fisher exact test and multivariate analysis using logistic regression models. Esophageal fistula was observed in 31 patients (22%). Of these, 6 patients developed fistula during CRT. Median time interval between the date of CRT initiation and that of fistula diagnosis was 100 days (inter quartile range, 45–171). Esophageal stenosis was the only significant risk factor for esophageal fistula formation both in univariate (P = 0.026) and in multivariate analyses (odds ratio, 2.59; 95% confidence interval, 1.13–5.92, P = 0.025). Other clinicopathological factors, namely treatment arm, age, sex, PS, primary tumor location, T stage, lymph node invasion to adjacent organs, blood cell count, albumin level, and body mass index, were not risk factors fistula formation. Esophageal stenosis was a significant risk factor for esophageal fistula formation in patients treated with CRT for unresectable locally advanced thoracic esophageal squamous cell carcinoma.
科研通智能强力驱动
Strongly Powered by AbleSci AI