Esophageal Metal Stents with Concurrent Chemoradiation Therapy for Locally Advanced Esophageal Cancer: Safe or Not?

被引：14

作者：

Lu, Yueh-Feng ^{[1
]}

Chung, Chen-Shuan ^{[2
,6
]}

Liu, Chao-Yu ^{[3
,7
]}

Shueng, Pei-Wei ^{[1
,7
,11
]}

Wu, Le-Jung ^{[1
]}

Hsu, Chen-Xiong ^{[1
,9
]}

Kuo, Deng-Yu ^{[1
]}

Hou, Pei-Yu ^{[1
]}

Chou, Hsiu-Ling ^{[4
,10
,12
]}

Leong, Ka-, I ^{[3
]}

How, Cheng-Hung ^{[1
]}

Chou, San-Fang ^{[5
]}

Wang, Li-Ying ^{[13
,14
]}

Hsieh, Chen-Hsi ^{[1
,7
,8
]}

机构：

[1] Far Eastern Mem Hosp, Div Radiat Oncol, Dept Radiol, 21 Sec 2,Nanya S Rd, New Taipei 220, Taiwan

[2] Far Eastern Mem Hosp, Div Gastroenterol & Hepatol, Dept Internal Med, New Taipei, Taiwan

[3] Far Eastern Mem Hosp, Div Thorac Surg, Dept Surg, New Taipei, Taiwan

[4] Far Eastern Mem Hosp, Dept Nursing, New Taipei, Taiwan

[5] Far Eastern Mem Hosp, Dept Med Res, New Taipei, Taiwan

[6] Fu Jen Catholic Univ, Coll Med, New Taipei, Taiwan

[7] Natl Yang Ming Univ, Fac Med, Taipei, Taiwan

[8] Natl Yang Ming Univ, Inst Tradit Med, Sch Med, Taipei, Taiwan

[9] Natl Yang Ming Univ, Dept Biomed Imaging & Radiol Sci, Taipei, Taiwan

[10] Natl Yang Ming Univ, Sch Nursing, Taipei, Taiwan

[11] Triserv Gen Hosp, Dept Radiat Oncol, Natl Def Med Ctr, Taipei, Taiwan

[12] Oriental Inst Technol, Dept Nursing, New Taipei, Taiwan

[13] Natl Taiwan Univ Hosp, Phys Therapy Ctr, Taipei, Taiwan

[14] Natl Taiwan Univ, Coll Med, Sch & Grad Inst Phys Therapy, Taipei, Taiwan

来源：

ONCOLOGIST | 2018年 / 23卷 / 12期

关键词：

Esophageal squamous cell carcinoma; Self-expandable metal stents; Concurrent chemoradiation therapy; Esophageal fistula; NEOADJUVANT THERAPY; CHEMORADIOTHERAPY; PALLIATION; DYSPHAGIA; RADIOTHERAPY; OBSTRUCTION; CISPLATIN; INSERTION; OUTCOMES; SOCIETY;

D O I：

10.1634/theoncologist.2017-0646

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background. The purpose of this study was to review the risks and benefits of concurrent chemoradiation therapy (CCRT) with esophageal self-expandable metal stents (SEMS) for the treatment of locally advanced esophageal cancer. Materials and Methods. Between January 2014 and December 2016, the data from 46 locally advanced esophageal cancer patients who received CCRT at our institution were retrospectively reviewed. Eight patients who received CCRT concomitant with SEMS placement (SEMS plus CCRT group) and thirty-eight patients who received CCRT without SEMS placement (CCRT group) were identified. The risk of developing esophageal fistula and the overall survival of the two groups were analyzed. Results. The rate of esophageal fistula formation during or after CCRT was 87.5% in the SEMS plus CCRT group and 2.6% in the CCRT group. The median doses of radiotherapy in the SEMS plus CCRT group and the CCRT group were 47.5 Gy and 50 Gy, respectively. SEMS combined with CCRT was associated with a greater risk of esophageal fistula formation than CCRT alone (hazard ratio [HR], 72.30; 95% confidence interval [CI], 8.62-606.12; p < .001). The median overall survival times in the SEMS plus CCRT and CCRT groups were 6 months and 16 months, respectively. Overall survival was significantly worse in the SEMS plus CCRT group than in the CCRT group (HR, 5.72; 95% CI, 2.15-15.21; p < .001). Conclusion. CCRT concomitant with SEMS for locally advanced esophageal cancer results in earlier life-threatening morbidity and a higher mortality rate than treatment with CCRT alone. Further prospective and randomized studies are warranted to confirm these observations.

引用

页码：1426 / 1435

页数：10

共 37 条

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