Clinical Application Of Oral Meglumine Diatrizoate Esophagogram In Screening Esophageal Fistula During Radiotherapy For Esophageal Cancer

PURPOSE:Radiotherapy is an effective treatment for esophageal cancer,esophageal fistula is the most serious complication during radiotherapy for esophageal cancer.There is a high mortality rate after esophageal fistula formed with adjacent tissues and organs.This study aimed to investigate the sensitivity andspecificity of oral meglumine diatrizoate esophagogram in screening for esophageal fistula during radiotherapy for esophageal cancer,anddiscussif early detection and treatmentcould improve the prognosis of esophageal fistulas.Methods:According to the inclusion criteria,patients with stage Ⅰ-Ⅳesophageal cancer confirmed by pathology were treated with radiotherapy.the patients oral meglumine diatrizoateevery week for esophagogram during radiotherapy.If esophageal fistula occurs,further diagnosis was made byfiber-esophagoscopy or computed tomography(CT).After diagnosis of esophageal fistula,radiotherapy was stopped and symptomatic treatment was given,meglumine diatrizoate was used for re-examination every week.If esophageal fistula recovered,radiotherapy plan was continued.spss22.0 statistical software was used for statistical analysis,and P<0.05 was statistically significant.Results:Totally 206 patients were enrolled in this research,including 10 cases of esophageal fistula detected by meglumine diatrizoate esophagography,and 8 cases of confirmed esophageal fistula by fiber-esophagoscopy or CT.The incidence of esophageal fistula was 3.88%.Among them 62.50%(5 cases)recovered after 1-2 weeks of treatment and continued to completedradiotherapy until the end.Thesensitivity of meglumine diatrizoate esophagogram in screening esophageal fistula during radiotherapy for esophageal cancerwas 100%,the specificity was 98.99%,and the coincidence rate was 99.03%.The median follow-up time of esophageal fistula patients was 18.1 months(6-30 months),and the median survival time was 6.4 months(1.3-18.1 months).Notable side effects were diarrhea,with an incidence of 5.30%(11 cases of diarrhea),and no toxic side effects beyond Ⅲ level requiring special intervention.Conclusions:Oral meglumine diatrizoate esophagography has high sensitivity and specificity in screening for esophageal fistulas during radiotherapy and little side effect.Early diagnosis and timely intervention can improve the prognosis and prolong the survival period of patients.It can be used in esophageal cancer patients with high risk of esophageal fistula during radiotherapy.