Carcinoma esophagus with xeroderma pigmentosa: Case report on a rare association

Radiation in patients with diseases such as xeroderma pigmentosa (XP), systemic lupus erythematosus, and other connective diseases is a matter of concern because of higher incidence of toxicities. Here with, we are reporting a case of carcinoma esophagus with XP, who tolerated the treatment well with sufficiently prolonged palliation of symptoms, after treatment with external beam radiotherapy. This might be attributed to the different mechanisms of DNA damage and repair mechanisms for ultraviolet (UV) rays and X-rays. UV rays cause DNA damage by dimer formation whereas X-rays will cause single- or double-stranded breaks in DNA. The repair mechanisms for UV rays are nucleotide excision repair and translesion synthesis while for X-rays, they are base excision repair, homologous recombination, and nonhomologous end joining, and these repair mechanisms for X-rays are intact in a XP patient. Hence, they can be been treated with high dose of radiation, and they do tolerate the treatment well.