Respiratory tract fistulae in recurrent aerodigestive cancers after chemotherapy

K. S. Sridhar, L. Barreras, M. J. Saldana, H. Manten

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Bronchoesophageal fistulae, a form of respiratory tract fistula, occurred in four patients with squamous cell carcinoma arising in the esophagus or left bronchus after cytoreductive chemotherapy. All four had locoregional cancer, recurrent after high-dose external radiation therapy. Esophageal cancer was treated with sequential intravenous cisplatin 100 mg/m2 (day 1) and 5-fluorouracil (5-FU) 40 mg/m2/hour x 120 (days 2-7). Lung cancer was treated with sequential intravenous cisplatin 100 mg/m2 (day 1), 5-FU 40 mg/m2/hour x 72 (days 2-5), and etoposide 80 mg/m2/day x 3 (days 2, 3, and 4). All patients had symptomatic relief and tumor regression after oncolytic chemotherapy, which was well tolerated with no hematologic toxicity. After the second or third cycle of chemotherapy, bronchoesophageal fistula occurred in all four patients with manifestations of pneumonia, which proved fatal in two patients. The other two patients were effectively palliated for 14 and 36+ weeks after celestin tube placement. Bronchoesophageal fistula should be managed by antibiotics and respiratory support followed by elective placement of celestin tube in most patiens and by esophageal exclusion or esophageal bypass in a few select patients. In aerodigestive cancers, respiratory tract fistula may be a rare and potentially fatal complication of chemotherapy induced tumor lysis.

Original languageEnglish
Pages (from-to)247-251
Number of pages5
JournalCancer
Volume61
Issue number2
StatePublished - Jan 1 1988
Externally publishedYes

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Respiratory Tract Fistula
Drug Therapy
Fistula
Neoplasms
Fluorouracil
Cisplatin
Etoposide
Bronchi
Esophageal Neoplasms
Esophagus
Squamous Cell Carcinoma
Lung Neoplasms
Pneumonia
Radiotherapy
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Sridhar, K. S., Barreras, L., Saldana, M. J., & Manten, H. (1988). Respiratory tract fistulae in recurrent aerodigestive cancers after chemotherapy. Cancer, 61(2), 247-251.

Respiratory tract fistulae in recurrent aerodigestive cancers after chemotherapy. / Sridhar, K. S.; Barreras, L.; Saldana, M. J.; Manten, H.

In: Cancer, Vol. 61, No. 2, 01.01.1988, p. 247-251.

Research output: Contribution to journalArticle

Sridhar, KS, Barreras, L, Saldana, MJ & Manten, H 1988, 'Respiratory tract fistulae in recurrent aerodigestive cancers after chemotherapy', Cancer, vol. 61, no. 2, pp. 247-251.
Sridhar KS, Barreras L, Saldana MJ, Manten H. Respiratory tract fistulae in recurrent aerodigestive cancers after chemotherapy. Cancer. 1988 Jan 1;61(2):247-251.
Sridhar, K. S. ; Barreras, L. ; Saldana, M. J. ; Manten, H. / Respiratory tract fistulae in recurrent aerodigestive cancers after chemotherapy. In: Cancer. 1988 ; Vol. 61, No. 2. pp. 247-251.
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