G. Perrier et al., Squamous cell carcinoma of the thoracic esophagus following radiation therapy for breast cancer, HEP-GASTRO, 45(24), 1998, pp. 2197-2201
Between 1981 and 1995, 4 patients (3 females, 1 male; aged 48-80) were diag
nosed with squamous cell carcinoma of the esophagus, following mediastinal
irradiation for breast cancer. The interval between irradiation and the pre
sentation of esophagal cancer was 10.75 years on average (7-19). The treatm
ent consisted of: radiotherapy only; a partial esophagectomy with proximal
gastrectomy without post-operative radiotherapy; laser photocoagulation for
a superficial tumor; and, palliative treatment including gastrostomy, trac
heal photocoagulation and chemotherapy for 1 patient suffering from advance
d stage cancer with tracheal invasion, respectively. Radiotherapy of the es
ophagal cancer (exclusive or adjuvant) should take into account previous es
ophageal radiation therapy. The indications of curative excision surgery ar
e the same as for other types of esophageal cancer, but the anastomoses sho
uld be performed in a non-irradiated area. Excision by esophageal stripping
without thoracotomy is contraindicated because of the presence of peri-eso
phageal sclerosis. Preventive measures in radiation therapy for breast canc
er are suggested.