https://scholars.lib.ntu.edu.tw/handle/123456789/506293
標題: | Esophageal Metal Stents with Concurrent Chemoradiation Therapy for Locally Advanced Esophageal Cancer: Safe or Not? | 作者: | Lu Y.-F. Chung C.-S. Liu C.-Y. Shueng P.-W. Wu L.-J. Hsu C.-X. Kuo D.-Y. Hou P.-Y. Chou H.-L. Leong K.-I. How C.-H. Chou S.-F. LI-YING WANG Hsieh C.-H. |
關鍵字: | Concurrent chemoradiation therapy; Esophageal fistula; Esophageal squamous cell carcinoma; Self-expandable metal stents | 公開日期: | 2018 | 出版社: | Wiley-Blackwell | 卷: | 23 | 期: | 12 | 起(迄)頁: | 1426-1435 | 來源出版物: | Oncologist | 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. Implications for Practice: Patients treated with SEMS placement followed by CCRT had higher risk of esophageal fistula formation and inferior overall survival rate compared with patients treated with CCRT alone. SEMS placement should be performed cautiously in patients who are scheduled to receive CCRT with curative intent. ? AlphaMed Press 2018 |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85046358037&doi=10.1634%2ftheoncologist.2017-0646&partnerID=40&md5=22fa92dedd7e8e312acdfed8d10e410e https://scholars.lib.ntu.edu.tw/handle/123456789/506293 |
ISSN: | 1083-7159 | DOI: | 10.1634/theoncologist.2017-0646 | SDG/關鍵字: | cisplatin; fluorouracil; folinic acid; paclitaxel; adult; aged; Article; bronchoscopy; cancer staging; chemoradiotherapy; clinical article; computed tomographic angiography; computer assisted tomography; dysphagia; endoscopic retrograde cholangiopancreatography; endoscopy; esophageal squamous cell carcinoma; esophagogastroduodenoscopy; esophagus cancer; esophagus fistula; esophagus resection; female; follow up; hazard ratio; human; human tissue; lymph node metastasis; male; metastasis; middle aged; mortality rate; overall survival; positron emission tomography-computed tomography; priority journal; radiation dose; retrospective study; risk factor; squamous cell carcinoma; stent migration; thorax pain; tumor volume; chemoradiotherapy; esophagus tumor; multimodality cancer therapy; pathology; procedures; squamous cell carcinoma; stent; Aged; Carcinoma, Squamous Cell; Chemoradiotherapy; Combined Modality Therapy; Esophageal Neoplasms; Female; Humans; Male; Middle Aged; Retrospective Studies; Stents |
顯示於: | 物理治療學系所 |
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