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Tracheoesophageal fistula closure after staged dose-escalated radiotherapy for esophageal squamous cell carcinoma: a case report

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机构: [1]No. 5 Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China [2]No. 1 Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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关键词: Esophageal squamous cell carcinoma tracheoesophageal fistula hemoptysis staged dose-escalated radiotherapy case report fistula closure

摘要:
An esophageal fistula can be caused by an esophageal tumor as well as the surgery, radiotherapy (RT), or chemoradiotherapy used to treat the tumor. The most dangerous complications are massive hemoptysis and asphyxia. This report describes a 58-year-old man with a >1-month history of dysphagia and hemoptysis. Contrast-enhanced computed tomography revealed a tumor in the upper esophagus and a tracheoesophageal fistula. Esophagography revealed a large lesion measuring approximately 8 cm in length. Esophagogastroduodenoscopy showed an ulcerated tumor with raised margins originating 22 cm from the incisors, and histologic examination of a biopsy specimen indicated squamous cell carcinoma. The tumor was finally classified as stage IVA (T4bN0M0) esophageal squamous cell carcinoma. Massive hemoptysis occurred after the patient was admitted to the hospital. Therefore, we applied staged dose-escalated RT in three stages (6.0 Gy in 5 fractions, 7.5 Gy in 5 fractions, and 46.8 Gy in 26 fractions) to decrease the rate of tumor shrinkage brought on by RT and give the normal tissue enough time to close the fistula. Finally, the hemoptysis resolved and the patient's symptoms were significantly improved. Contrast-enhanced chest computed tomography revealed shrinkage of the tumor. In conclusion, staged dose-escalated RT can be applied for esophageal fistula closure.

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出版当年[2023]版:
大类 | 4 区 医学
小类 | 4 区 医学:研究与实验 4 区 药学
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 医学:研究与实验 4 区 药学
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出版当年[2023]版:
Q4 MEDICINE, RESEARCH & EXPERIMENTAL Q4 PHARMACOLOGY & PHARMACY
最新[2024]版:
Q3 MEDICINE, RESEARCH & EXPERIMENTAL Q4 PHARMACOLOGY & PHARMACY

影响因子: 最新[2024版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版] 出版后一年[2024版]

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第一作者机构: [1]No. 5 Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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通讯机构: [1]No. 5 Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China [*1]No. 5 Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, No. 12 Jiankang Road, Shijiazhuang, Hebei 050011, China
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