Purpose: The aim of this study was to investigate risk factors for
esophageal squamous cell carcinoma (ESCC) treated with
radiotherapy (RT) with or without
chemotherapy to guide how to reduce the occurrence of
esophageal fistula (EF). Methods: 414 patients with ESCC who underwent RT with or without
chemotherapy were collected in Shandong Cancer Hospital from February 2012 to June 2018 retrospectively. The clinical characters and dosimetric parameters were recorded. Univariate and multivariate logistic regression analyses were provided to determine the risk factors associated with EF. Results: The cumulative incidences of EF were 11.1% (46/414 patients). The median follow-up period was 15.8 months (range: 0.2-82.6months). The median survival time (MST) of patients with EF was 5.3 months. In univariate analysis, age, T4 stage, N3 stage,
chemotherapy regimens, re-RT, ulcerative
esophageal cancer (EC),
esophageal stenosis, the maximum thickness of the
tumor and the length of
tumor had a correlation with the prevalence of EF. In multivariable logistic regression analysis, T4 stage, N3 stage, re-RT, ulcerative EC,
esophageal stenosis, the maximum thickness of the
tumor was confirmed as risk factors for EF. Conclusion: This study revealed that T4 stage, N3 stage, re-RT, ulcerative EC,
esophageal stenosis, the maximum thickness of the
tumor were risk factors associated with EF. We ought to attach importance to the prevention of EF. Patients with risk factors for EF should be paid close attention.