Esophageal cancer secondary to radiotherapy: 2 patients

Öz

A complication of radiotherapy is the appearance of new malignancies. In this study, we document two patients with esophageal carcinoma after radiotherapy. Two women, 64 and 60 years old, presented to our department with dysphagia and weight loss. Both had undergone mastectomy and postoperative radiotherapy because of breast carcinoma 13 and 10 years ago, respectively. Diagnostic studies suggested esophageal carcinoma in these patients. Biopsies from the lesions were reported as squamous cell carcinoma. McKeown and Threefield procedures were applied for surgical treatment. Esophageal malignacy secondary to radiotherapy is one of the well-known subjects in literature. Because of the good prognosis in early stage esophageal cancer, patients with a history of radiotherapy to the chest should be monitored with a follow-up program for esophageal carcinoma risk.

Anahtar Kelimeler

• Breast carcinoma, radiotherapy, esophageal carcinoma

Radyoterapiye sekonder özofagus kanseri: 2 olgu sunumu

Öz

Radyoterapi komplikasyonları yeni malignensiler şeklinde ortaya çıkabilir. Bu çalışmada radyoterapi sonrası özofagus karsinomu gelişen 2 olgu sunulmuştur. Yaşları 64 ve 60 olan iki kadın hasta kliniğimize yutma güçlüğü ve kilo kaybı nedeniyle başvurmuştur. Bu hastalara meme kanseri nedeniyle sırasıyla 13 ve 10 yıl önce mastektomi ve postoperatif radyoterapi uygulanmıştır. Tanısal çalışmalarla bu hastalarda skuamöz hücreli özofagus kanseri olduğu ortaya konmuştur. Mc Keown ve Threefield prosedürleri cerrahi tedavi olarak uygulanmıştır. Radyoterapiye sekonder özofagus malinitesi gelişmesi literatürde iyi bilinen konulardan biridir. Erken evre özofagus kanserinin prognozu iyi olduğundan toraks bölgesine radyoterapi uygulanan hastalar özofagus kanseri açısından yakın kontrol programına alınmalıdır.

Anahtar Kelimeler

• Meme kanseri, radyoterapi, özofagus kanseri

Kaynakça

1. Bebe GW, Kato H, Land CE. Studies of the mortality of A-bomb sur- vivors. Radiat Res 1978 ; 75: 183-201.
2. Sadove AM, Block M , Rossf AH, et al. Radiation carcinogenesis in man. Cancer 1981; 48: 1139-43.
3. Hall EJ. Radiation carcinogenesis. in: Radiobiology for Radiolo- gists, 4thedn. Philadelphia: Lippincott 1994: 323-50.
4. Swerdlow AJ, Douglas AJ, Vaughan Hudson G. Risk of second pri- mary cancers after Hodgkin’s disease by type of the treatment: analysis of 2846 patients in the British national lymphoma investi- gation. BMJ 1992; 304: 1137-43.
5. Wright F, Wasan S, Mercer D. Radiation-induced esophageal squ- amous cell carcinoma in situ. Diseases of the Esophagus 2000; 13: 255-258.
6. Coia L R, Myerson R J, Teper J E. Late effects of radiation therapy on the gastrointestinal tract. Int J Radiation Oncol, Biol Phsics 1995; 31: 1213-1236.
7. Chowhan N M. Injurious effects of radiation on the esophagus. Am J Gastroenterolgy 1990; 85: 115-120.
8. Ron E. Ionizing radiation and cancer risk: evidence from epidemi- ology. Radiat Res 1998; 150: 30-41.

9. Epstein R, Hanham I, Dale R. Radiotherapy-induced second can- cers: are we doing enough to protect young patients? European J Cancer 1997; 33: w526-530.
10. Aisenberg A C, Finkelstein D M, Doppke K P. High risk of breast carcinoma after irradiation of young women with Hodgkin’s dise- ase. Cancer 1997; 79: 1203-1210.
11. Cahan WG, Woodard NL, Higinbotam N,et al. Sarcoma arising in irradiated bone. Reported of eleven cases. Cancer 1948; 1: 3-29.
12. Lewin K J, Dawsey S M, Wang G Q. Squamous carsinoma of the esophagus in China and the West: are they different disorders? Dis Esophag 1995; 8; 44-47.
13. Dawsey S M, Lewin K J, Wang G Q. Squamous esophageal histo- logy and subsequent risk of squamous cell carcinoma of the esopha- gus. A prospective follow-up study from Linxian, China. Cancer 1994; 74: 1686-1692.
14. Vanagunas A, Jacop P, Ollinger E. Radiation-induced esophageal injury: A spectrum from esophagitis to cancer. Am J Gastroentero- logy 1990; 85: 808-12.
15. Kapur TR. Late postradiation changes in the larynx, pharnyx, esop- hagus and the trachea. J Laryngol Otol 1968; 82: 447-457.
16. Hellmann S. Principles of radiation therapy. Cancer. Principles and practise of oncology. Philadelphia: JB Lippincott, 1989, 247-75.
17. Neugut AI, Winberg MD, Ahsan H. Carsinogenic effects of radiot- herapy for breast cancer. Oncology (Huntingt) 1999; 13: 1245-65.
18. Daly JM, Karnell LH, Menck HR. National cancer data base report on esophageal carcinoma . Cancer 1996; 78: 1820-8.
19. Varanasi RV, Saltzman JR, Krims P, et al. Breast carcinoma metas- tatic to the esophagus: clinicopathological and manegement featu- res of four cases and literature review. Am J Gastroenterol 1995; 90: 1495-9.