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Multivariable analysis demonstrated that age, ECLNIE, esophageal wall thickness, and niche sign by esophagogram before RT were independent risk factors for EP. After PSM, compared with patients without ECLNIE, patients with ESCC and ECLNIE had a significantly higher risk of EP. The presence of ECLNIE could be a strong risk factor of EP during and after RT. The presence of ECLNIE could be a strong risk factor of EP during and after RT. Although treatment of bone tumors is multidisciplinary, the complete surgical resection of bone tumors