Histopathological study of the esophageal injury induced by high-dose-rate intracavitary irradiation

Soejima, Toshinori; Kushima, Takeyuki; Kodama, Atsuko; Sakaguchi, Toshiya; Yonezawa, Kazuyuki; Hashimura, Takahisa; Imanaka, Kuniyasu; Šako, M.; Kono, Michio

doi:10.1016/0360-3016(91)90598-x

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“…Our previous report 10 also showed that almost all patients developed esophageal ulcer, and the occurrence of esophageal ulcer ranged from 5 to 12 months post therapy. Our experimental study 13 showed that esophageal ulcer healed 21 days after 15 Gy of intraluminal brachytherapy, however, recurred 6 months after. The time of occurrence of this esophageal ulcer is almost the same as the time of local relapse of esophageal cancer, so the differential diagnosis between radiation ulcer and cancer relapse was often difficult.…”

Section: Discussionmentioning

confidence: 64%

Case of radiation-induced esophageal ulcer worsened after endoscopic biopsy

Soejima

Nishimura

Endo

et al. 2002

Diseases of the Esophagus

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Esophageal ulcer is one of the most important late complications of the esophagus treated with radiation therapy, especially with intraluminal brachytherapy. We encountered a patient with esophageal cancer treated with external radiation therapy and intraluminal brachytherapy, who developed radiation ulcer and who had severe dysphagia soon after endoscopic biopsy of the ulcer edge. A 55-year-old man was diagnosed as esophageal cancer without symptoms. He received 60 Gy/30 Fr of external radiation therapy and 12 Gy/3 Fr of intraluminal brachytherapy at a point of 5 mm in depth from the mucosa surface. He developed an asymptomatic esophageal ulcer 13 months after treatment, and endoscopic biopsy was obtained from the edge of the ulcer. Thereafter, swallowing difficulties appeared, and endoscopy revealed severe esophageal stenosis and a deep ulcer. A possibility that the biopsy contributed to worsening the ulcer can be considered. Except for cases where relapse is apparent, endoscopic biopsy is considered to be avoided.

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Section: Discussionmentioning

confidence: 64%