Endoscopic findings of radiation esophagitis in concurrent chemoradiotherapy for intrathoracic malignancies

Background and purpose: The incidence and extent of radiation esophagitis w ere assessed endoscopically in patients treated with concurrent chemoradiot herapy. Patients and methods: Eighty-two patients who received thoracic radiotherap y for lung, thymic, or esophageal cancer were investigated endoscopically f rom July 1991 to the end of 1997. Among them, 23 esophageal cancer patients were treated with radiation alone, and the others were treated with concur rent chemoradiotherapy. Esophageal endoscopy was performed during or just a fter radiotherapy. The presence of radiation esophagitis was assessed and a ssigned an endoscopic score (i.e. grade 0 for normal, 1 for erythema, 2 for erosion or sloughing, 3 for ulcer, hemorrhage, or stricture). The symptoma tic grade was assessed using the RTOG (Radiation Therapy Oncology Group) ac ute radiation morbidity score. Results: A correlation was seen between endoscopic and RTOG scores. However , even some patients with RTOG grade 0 to 1 had endoscopic grade 3 esophagi tis. Endoscopic grade 3 was observed in 16 (27.1%) patients in the concurre nt chemoradiotherapy group, whereas it did not occur in any patient in the radiation alone group (P = 0.004). Conclusions: Our results suggest that (1) RTOG score correlates closely to esophageal mucosal damage, and (2) more severe esophagitis occurs in those undergoing radiotherapy alone. (C) 2001 Elsevier Science Ireland Ltd. All r ights reserved.