Radiation-induced esophageal strictures in children with cancer

The purpose of this study was to determine the long-term esophageal side effects of irradiation and (doxorubicin) chemotherapy given to children with cancer. Barium esophagograms and medical records of 18 patients with esophagitis who received between 1200 and 5580 cGy to the chest and chemotherapy were reviewed. The age range was 3-14 years. Esophageal strictures occurring 1-10 years after therapy were found in 5 patients with lymphoma; 3 of the five received doses of 4000 cGy or greater. Three children with esophagitis who received doses of 4000 cGy did not have stricture formation. However, their follow-up time was only 1-3 years. Of the 5 patients with esophageal stricture, 4 were treated with multiple dilatations, and a fifth required colonic interposition. Combined mediastinal irradiation and chemotherapy can result in esophageal stricture 1-10 years after therapy.