title: Advanced esophageal cancer with esophago-bronchial fistula successfully treated by chemoradiation therapy with additional endoscopic resection: a case report.
abstract: Chemoradiation is potentially curative for esophageal cancer in various stages, but local failure is a major problem. The present case was a 49-year-old male diagnosed with advanced esophageal cancer with an esophago-bronchial fistula and lymph node metastasis. Histological diagnosis by biopsy was adenosquamous cell carcinoma. Chemoradiotherapy comprising intravenous infusion of cisplatin and continuous infusion of 5-fluorouracil with concurrent radiation was initiated in July 1997. In December 1997, after four courses of therapy, partial remission was obtained and the fistula closed with a remnant polypoid lesion at the primary site, which remained even after six courses of treatment. In February 1998, endoscopic polypectomy was performed for the remnant lesion and histological examination revealed that it contained adenocarcinoma cells. Thereafter, no additional treatment was performed and the patient has been disease-free for 3.5 years. This case suggests that additional endoscopic resection is an optional treatment for local failure after chemoradiation.
authors.affiliation: Division of Digestive Endoscopy and Gastrointestinal Oncology and Division of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Morihiro
authors.forename: Narikazu
authors.initials: N
authors.lastname: Boku
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ohtsu
authors.forename: Shin'ichi
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ishikura
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001983:Bronchial Fistula / Q000150:complications*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D002945:Cisplatin / Q000008:administration & dosage; D004937:Esophageal Fistula / Q000150:complications*; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D004945:Esophagoscopy; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage
chemical_list: D002945:Cisplatin; D005472:Fluorouracil