Tracheoesophageal fistula closure after staged dose-escalated radiotherapy for esophageal squamous cell carcinoma: a case report
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 an...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-05-01
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| Series: | Journal of International Medical Research |
| Online Access: | https://doi.org/10.1177/03000605231172449 |
| _version_ | 1827949302886957056 |
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| author | Chan-jun Zhen Ping- Zhang Wen-wen Bai Yu-zhi Song Xue-ying Qiao Zhi-guo Zhou |
| author_facet | Chan-jun Zhen Ping- Zhang Wen-wen Bai Yu-zhi Song Xue-ying Qiao Zhi-guo Zhou |
| author_sort | Chan-jun Zhen |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-09T13:09:28Z |
| format | Article |
| id | doaj.art-b918e03509e04407a21c93e73697e3ab |
| institution | Directory Open Access Journal |
| issn | 1473-2300 |
| language | English |
| last_indexed | 2024-04-09T13:09:28Z |
| publishDate | 2023-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of International Medical Research |
| spelling | doaj.art-b918e03509e04407a21c93e73697e3ab2023-05-12T10:03:27ZengSAGE PublishingJournal of International Medical Research1473-23002023-05-015110.1177/03000605231172449Tracheoesophageal fistula closure after staged dose-escalated radiotherapy for esophageal squamous cell carcinoma: a case reportChan-jun ZhenPing- ZhangWen-wen BaiYu-zhi SongXue-ying QiaoZhi-guo ZhouAn 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.https://doi.org/10.1177/03000605231172449 |
| spellingShingle | Chan-jun Zhen Ping- Zhang Wen-wen Bai Yu-zhi Song Xue-ying Qiao Zhi-guo Zhou Tracheoesophageal fistula closure after staged dose-escalated radiotherapy for esophageal squamous cell carcinoma: a case report Journal of International Medical Research |
| title | Tracheoesophageal fistula closure after staged dose-escalated radiotherapy for esophageal squamous cell carcinoma: a case report |
| title_full | Tracheoesophageal fistula closure after staged dose-escalated radiotherapy for esophageal squamous cell carcinoma: a case report |
| title_fullStr | Tracheoesophageal fistula closure after staged dose-escalated radiotherapy for esophageal squamous cell carcinoma: a case report |
| title_full_unstemmed | Tracheoesophageal fistula closure after staged dose-escalated radiotherapy for esophageal squamous cell carcinoma: a case report |
| title_short | Tracheoesophageal fistula closure after staged dose-escalated radiotherapy for esophageal squamous cell carcinoma: a case report |
| title_sort | tracheoesophageal fistula closure after staged dose escalated radiotherapy for esophageal squamous cell carcinoma a case report |
| url | https://doi.org/10.1177/03000605231172449 |
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