Gastric mucosal injury and hemorrhage after definitive chemoradiotherapy for locally advanced esophageal cancer.
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ adverse effects
Carcinoma, Squamous Cell
/ secondary
Chemoradiotherapy
/ adverse effects
Cisplatin
/ administration & dosage
Endoscopy, Gastrointestinal
Esophageal Neoplasms
/ pathology
Esophagus
/ pathology
Female
Fluorouracil
/ administration & dosage
Gastric Mucosa
/ diagnostic imaging
Gastrointestinal Hemorrhage
/ etiology
Humans
Male
Middle Aged
Radiation Injuries
/ diagnostic imaging
Risk Factors
Stomach Diseases
/ etiology
Tomography, X-Ray Computed
Chemoradiotherapy
Esophageal cancer
Mucosal injury
Stomach
Journal
Esophagus : official journal of the Japan Esophageal Society
ISSN: 1612-9067
Titre abrégé: Esophagus
Pays: Japan
ID NLM: 101206627
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
26
05
2018
accepted:
16
06
2019
pubmed:
22
6
2019
medline:
15
7
2020
entrez:
22
6
2019
Statut:
ppublish
Résumé
Definitive chemoradiotherapy is one of the treatment options for locally advanced esophageal cancer with curative intent. Esophagitis and pharyngitis are well-known adverse events that occur during chemoradiotherapy, but gastric mucosal injury has been less frequently reported compared to mucositis. Importantly, gastric mucosal injury is not well known, hard to manage, and sometimes fatal. Hence, we examined the clinical characteristics and the incidence of gastric mucosal injury after CRT for esophageal cancer. The medical records of patients who received definitive chemoradiotherapy combined with 5-fluorouracil and cisplatin for stage II/III (nonT4) esophageal squamous cell carcinoma from January 2001 to December 2010 at our institute were reviewed retrospectively. We investigated 256 patients in whom, data for endoscopic abdomen examinations were both before and after CRT were available. Gastric mucosal damage was observed in 90 patients (35%) (grade 1/2/3 = 69/18/3). One of the possible risk factors identified in this study was the irradiation dose to abdomen. Compared to patients with cervical esophagus-upper thoracic esophagus tumor location, patients with middle thoracic esophagus-abdominal esophagus tumor location were more likely to develop gastric mucosal damage, although there was no statistically significant difference. It is important to consider gastric mucosal injury in patients who receive CRT, particularly when the irradiation field includes stomach.
Sections du résumé
BACKGROUND
Definitive chemoradiotherapy is one of the treatment options for locally advanced esophageal cancer with curative intent. Esophagitis and pharyngitis are well-known adverse events that occur during chemoradiotherapy, but gastric mucosal injury has been less frequently reported compared to mucositis. Importantly, gastric mucosal injury is not well known, hard to manage, and sometimes fatal. Hence, we examined the clinical characteristics and the incidence of gastric mucosal injury after CRT for esophageal cancer.
METHODS
The medical records of patients who received definitive chemoradiotherapy combined with 5-fluorouracil and cisplatin for stage II/III (nonT4) esophageal squamous cell carcinoma from January 2001 to December 2010 at our institute were reviewed retrospectively.
RESULTS
We investigated 256 patients in whom, data for endoscopic abdomen examinations were both before and after CRT were available. Gastric mucosal damage was observed in 90 patients (35%) (grade 1/2/3 = 69/18/3). One of the possible risk factors identified in this study was the irradiation dose to abdomen. Compared to patients with cervical esophagus-upper thoracic esophagus tumor location, patients with middle thoracic esophagus-abdominal esophagus tumor location were more likely to develop gastric mucosal damage, although there was no statistically significant difference.
CONCLUSIONS
It is important to consider gastric mucosal injury in patients who receive CRT, particularly when the irradiation field includes stomach.
Identifiants
pubmed: 31222680
doi: 10.1007/s10388-019-00680-1
pii: 10.1007/s10388-019-00680-1
doi:
Substances chimiques
Cisplatin
Q20Q21Q62J
Fluorouracil
U3P01618RT
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
402-407Références
Gastrointest Endosc. 2000 Apr;51(4 Pt 1):498-9
pubmed: 10744835
Ann Thorac Surg. 2005 Sep;80(3):1115-7
pubmed: 16122506
Gastrointest Endosc. 2010 Aug;72(2):452-3
pubmed: 20226458
Int J Radiat Oncol Biol Phys. 2011 Nov 1;81(3):684-90
pubmed: 20932658
Int J Radiat Oncol Biol Phys. 2011 Dec 1;81(5):1343-51
pubmed: 20934268
CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
pubmed: 21296855
Gastrointest Endosc. 2012 Jun;75(6):1285-6
pubmed: 21821253
Ann Surg Oncol. 2012 Jan;19(1):68-74
pubmed: 21879261
Int J Radiat Oncol Biol Phys. 2012 Oct 1;84(2):369-75
pubmed: 22381898
Bone Marrow Transplant. 2013 Mar;48(3):452-8
pubmed: 23208313
World J Gastroenterol. 2012 Dec 28;18(48):7402-4
pubmed: 23326152
Gut Liver. 2013 Jan;7(1):106-11
pubmed: 23423146
Anticancer Res. 2013 Apr;33(4):1737-41
pubmed: 23564825
Jpn J Clin Oncol. 2013 Jun;43(6):608-15
pubmed: 23585687
Esophagus. 2016;13:110-137
pubmed: 27110229
Int J Radiat Oncol Biol Phys. 1995 Mar 30;31(5):1213-36
pubmed: 7713784