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Effects of mediastinal irradiation on oesophageal function
E Yeoh1, R H Holloway, A Russo
1Department of Radiation Oncology, Royal Adelaide Hospital, South Australia.
Gut
|February 1, 1996
Summary
Mediastinal irradiation for thoracic cancers commonly causes esophageal symptoms like pain or difficulty swallowing. These symptoms are not due to changes in esophageal function but likely result from increased mucosal sensitivity.
Area of Science:
- Oncology
- Gastroenterology
- Radiotherapy
Background:
- Mediastinal irradiation for intrathoracic malignancies frequently causes esophageal symptoms.
- The precise mechanisms underlying these esophageal sequelae remain poorly understood.
Purpose of the Study:
- To prospectively investigate the effects of mediastinal irradiation on esophageal function.
- To clarify the pathogenesis of esophageal symptoms during and after radiotherapy.
Main Methods:
- Prospective evaluation of eight patients undergoing mediastinal irradiation.
- Assessment included esophageal symptoms, barium swallow, endoscopy, radionuclide scintigraphy, and manometry.
- Evaluations were performed pre-treatment, during irradiation, and post-treatment.
Main Results:
- Odynophagia or dysphagia occurred in all but one patient during irradiation (p < 0.001).
- Endoscopic abnormalities were infrequent and did not correlate with symptoms.
- Mediastinal irradiation did not significantly alter esophageal motility or transit.
Conclusions:
- Esophageal symptoms during mediastinal irradiation are not caused by impaired esophageal motility or transit.
- Increased esophageal mucosal sensitivity is a likely contributor to these symptoms.
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