ArticlePloS one2021
Esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal squamous cell carcinoma.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Efficacy of thoracic endovascular aortic repair for aorto-esophageal fistula due to esophageal cancer: a systematic review and meta-analysis.Esophagus : official journal of the Japan Esophageal Society · 2024Pooled it
- Novel Musculocutaneous Flap for Salvage Esophageal Reconstruction.Annals of thoracic surgery short reports · 2026Article
- Successful Staged Surgery for Esophagopulmonary Fistula with Lung Abscess During Neoadjuvant Chemoradiotherapy.Journal of clinical medicine · 2026Article
- Three cases of esophagorespiratory fistula following neoadjuvant DCF therapy for resectable esophageal cancer.International cancer conference journal · 2026Article
- Establishing an esophago-pleural fistula disease model in rabbits with a magnetic compression technique.World journal of gastroenterology · 2026Article
- Clinical Outcomes in Patients With T4b Esophageal Squamous Cell Carcinoma: A 10-Year Single Institution Experience.The Kaohsiung journal of medical sciences · 2026Article
- Safety of long-term esophageal stent placement and a predictive model for restenosis: A double-center retrospective study.Surgical endoscopy · 2026Article
- Catastrophic Esophageal Tumor Perforation within One Week after First-Line Chemo-Immunotherapy for Advanced Esophageal Squamous Cell Carcinoma: A Case Report.Surgical case reports · 2026Article
- Article
- Real-world study of first-line immunotherapy combined with chemoradiotherapy in esophageal squamous cell carcinoma.Scientific reports · 2025Article
- A retrospective cohort study on radio/chemotherapy and survival following esophageal fistula in esophageal cancer patients with prior radiotherapy.BMC cancer · 2025Article
- Induction Radiochemotherapy for Esophageal Cancer: Long-Term Outcomes from a Single-Center Study.Journal of clinical medicine · 2025Article
- Comparison of radiation esophagitis associated with daytime versus evening radiotherapy in patients with esophageal carcinoma.Radiation oncology (London, England) · 2025Article
- Case Report: Apatinib combined with IMRT concurrent therapy achieves rapid response and significantly prolongs progression-free survival in elderly patients with inoperable locally advanced esophageal squamous cell carcinoma.Frontiers in oncology · 2025Article
- Case Report: Esophago-pleural fistula found by the squamous cells from pleural effusion.Frontiers in oncology · 2025Article
- Prediction of esophageal fistula in radiotherapy/chemoradiotherapy for patients with advanced esophageal cancer by a clinical-deep learning radiomics model : Prediction of esophageal fistula in radiotherapy/chemoradiotherapy patients.BMC medical imaging · 2024Article
- Aortoesophageal fistula due to esophageal cancer: a case report of successful management.Surgical case reports · 2024Article
- Prediction of malignant esophageal fistula in esophageal cancer using a radiomics-clinical nomogram.European journal of medical research · 2024Article
- Clinical-radiomics nomogram for the risk prediction of esophageal fistula in patients with esophageal squamous cell carcinoma treated with intensity-modulated radiation therapy or volumetric-modulated arc therapy.Journal of thoracic disease · 2024Article
- Multi-omics and Multi-VOIs to predict esophageal fistula in esophageal cancer patients treated with radiotherapy.Journal of cancer research and clinical oncology · 2024Article
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe literature regarding esophageal fistula after definitive concurrent chemotherapy and intensity modulated radiotherapy (IMRT) for esophageal squamous cell carcinoma (ESCC) remains lacking. We aimed to investigate the risk factors of esophageal fistula among ESCC patients undergoing definitive concurrent chemoradiotherapy (CCRT) via IMRT technique.
methodsA total of 129 consecutive ESCC patients receiving definitive CCRT with IMRT between 2008 and 2018 were reviewed. The cumulative incidence of esophageal fistula and survival of patients were estimated by the Kaplan-Meier method and compared between groups by the log-rank test. The risk factors of esophageal fistula were determined with multivariate Cox proportional hazards regression analysis.
resultsMedian follow-up was 14.9 months (IQR, 7.0-28.8). Esophageal perforation was identified in 20 (15.5%) patients, resulting in esophago-pleural fistula in nine, esophago-tracheal fistula in seven, broncho-esophageal fistula in two, and aorto-esophageal fistula in two patients. The median interval from IMRT to the occurrence of esophageal fistula was 4.4 months (IQR, 3.3-10.1). Patients with esophageal fistula had an inferior median overall survival (10.0 vs. 17.2 months, p = 0.0096). T4 (HR, 3.776; 95% CI, 1.383-10.308; p = 0.010) and esophageal stenosis (HR, 2.601; 95% CI, 1.053-6.428; p = 0.038) at baseline were the independent risk factors for esophageal fistula. The cumulative incidence of esophageal fistula was higher in patients with T4 (p = 0.018) and pre-treatment esophageal stenosis (p = 0.045). There was a trend toward better survival after esophageal fistula among patients receiving repair or stenting for the fistula than those only undergoing conservative treatments (median survival, 5.9 vs. 0.9 months, p = 0.058).
conclusionsT4 and esophageal stenosis at baseline independently increased the risk of esophageal fistula in ESCC treated by definitive CCRT with IMRT. There existed a trend toward improved survival after the fistula among patients receiving repair or stenting for esophageal perforation.
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