Caustic esophageal burn is a common ailment in clinical practice. In some patients, scar stricture was formed in the late stage of injury, and it seriously undermined quality of life of the patients. We adopted various clinical interventions at an early stage in order to relieve and alleviate the formation and development of corrosive esophageal stricture as a result of chemical injury as well as to avoid invasive operations to make it more acceptable for the patients. This article summarized the progress in etiology, pathological changes, identification, early prevention, and surgical management of corrosive esophageal stricture.
Burns ; complications ; pathology ; Constriction, Pathologic ; etiology ; pathology ; Esophageal Stenosis ; etiology ; pathology ; Esophagus ; injuries ; pathology ; Humans

CyberKnife is an image-guided robotic system designed for stereotactic radiosurgery. It uses the combination of robotics and image guidance to deliver concentrated and accurate beams of radiation to intracranial and extracranial targets. Although the frameless nature of the CyberKnife allows tumors in the chest and abdomen to be treated as well, complications associated with CyberKnife treatment have not been established yet due to its short clinical experience. We describe a case of localized esophageal ulcerations after CyberKnife treatment for metastatic hepatic tumor of colon cancer.
Aged ; Colonic Neoplasms/*pathology ; Esophagus/*injuries/pathology ; Humans ; Liver Neoplasms/*secondary/*surgery ; Male ; Radiosurgery/*adverse effects/instrumentation ; *Robotics ; Ulcer/etiology/pathology

OBJECTIVETo explore the clinical and physical factors that might give rise to radiation-induced esophagitis in three-dimensional conformal radiotherapy for non-small cell lung cancer.

METHODSTo collect the clinical and physical records and follow-up information of 106 NSCLC patients without undergoing surgery in our hospital. χ(2) test, linear tendency test and analysis of variance were employed to analyze the relationship between occurrence of radiation-induced esophagitis and clinical and physical treatment. Logistic analysis was also used for multivariate analysis.

RESULTSAmong the 47 cases of radiation-induced esophagitis, 31 cases were of grade I, 11 of grade II, 5 of grade III, and with a total occurrence rate of 44.3% (47/106). Radiation-induced esophagitis was correlated with Karnofsky scores, radiation sensitization and tumor location (χ(2) = 11.30, 8.45, 7.67, P < 0.05). Radiation-induced esophagitis was correlated with the length of irradiated esophagus and average dose of irradiated esophagus (F = 20.82, 83.08, P < 0.001). With the increase of the irradiated volume percentage from V20, V30, V40 up to V50, the occurrence rate of radiation-induced esophagitis was also increased, almost with a linear trend (P < 0.05). Application of all the above factors to logistic model indicated that radiation sensitization,length of irradiated esophagus, average dose and V50 were all statistically significant foactors in the occurrence of radiation-induced esophagitis (OR = 0.321, 2.850, 7.307 and 8.558, P < 0.05).

CONCLUSIONSRadiation sensitization,length of irradiated esophagus, average dose of irradiated esophagus and V50 are independent factors in the occurrence of radiation-induced esophagitis. V50 is of greater importance in the judgement of occurrence of radiation-induced esophagitis.

Aged ; Carcinoma, Non-Small-Cell Lung ; radiotherapy ; Esophagitis ; etiology ; Esophagus ; pathology ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; radiotherapy ; Male ; Middle Aged ; Multivariate Analysis ; Radiation Injuries ; etiology ; Radiation Tolerance ; Radiotherapy Dosage ; Radiotherapy, Conformal ; adverse effects ; methods ; Retrospective Studies

OBJECTIVETo decrease lung and esophageal radiation injuries by reducing irradiation target volume of mediastinal lymph mode drainage in conformal radiotherapy (CRT) for patients with non-small cell lung cancer (NSCLC) after thoracic surgery.

METHODSFifty-three patients with NSCLC were randomized into groups A and B to receive 3D-CRT after thoracic surgery. Patients in group A, according to conventional therapy, received preventive nodal irradiation (PNI) of the mediastinal lymph node drainage, and those in group B, according to pathological nodal staging after operation, did not have PNI of the metastasis-free area to reduce the clinical target volume (CTV). Patients in both groups were treated with conventional fractionated radiotherapy (CFRT) at 2 Gy in each fraction, and 5 fractions each week. All patients were followed up for two years to record their 2-year survival rate, local relapse of lymph node drainage and lung and esophageal radiation injuries.

RESULTSThe total 2-year survival rate was 58.5%in these patients and comparable between the two groups. The rates of local regional relapse and recurrence out of the CTV were 13.8% and 3.4% in group A and 16.7% and 8.3% in group B, respectively (P=1 and P=0.571). The incidence of radiation pneumonia and lung fibrosis were 6.9% and 62.1% in group A and 0% and 58.3% in group B (P=0.459 and P=0.782), and that of radiation esogphagitis and esophagus stricture rates were 27.6% and 6.9% in group A and 12.5% and 4.2% in group B, respectively (P=0.039 and P=1).

CONCLUSIONReduced CTV does not warrant decrease in the local control but may lower the incidence of acute esophageal radiation injury in postoperative patients with NSCLC.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; pathology ; radiotherapy ; surgery ; Drainage ; Esophagus ; pathology ; radiation effects ; Female ; Humans ; Lung ; pathology ; radiation effects ; Lung Neoplasms ; diagnostic imaging ; pathology ; radiotherapy ; surgery ; Lymph Nodes ; surgery ; Male ; Mediastinum ; Middle Aged ; Organ Size ; Radiation Injuries ; prevention & control ; Radiotherapy, Conformal ; adverse effects ; Recurrence ; Survival Rate ; Thoracic Surgery ; Tomography, X-Ray Computed

OBJECTIVETo investigate the effect of Modified Zhuye Shigao Decoction (MZSD) and its components on preventing radiation esophagitis of rats.

METHODSOne hundred Wistar rats were randomly divided into 5 groups, including the control group, radiation model group, MZSD group, Zhuye Shigao Decoction (ZSD) group, and added ingredients group, 20 rats in each group. The model of radiation esophagitis of rat was established by once local radiation of 40 Gy (330 Mu/min) with a high energy linear accelerator. The administration of Chinese medicine was continued for 14 days from 7 days before radiation application in the three treatment groups. On the 7th and 14th day, the serum was isolated and the levels of inflammatory cytokines tumor necrosis factor (TNF-α), interleukin 1β (IL-1β) and IL-8 were tested. The pathological slices of esophagus were obtained, and the pathological changes were observed. During the whole process, weight and food intake were recorded each day.

RESULTSOn the 7th day after radiation, the esophagus of rats in the MZSD group was almost intact, and the pathological injury score was significantly lower than that of the radiation model group, ZSD group and added ingredients group (P<0.01). Compared with the control group, the body weight and food intake of rats in the radiation model group were significantly decreased, and the levels of TNF-α, IL-1β and IL-8 were significantly increased (P<0.05 or P<0.01), while the MZSD group showed a significant increase in body weight and food intake, and a significant decrease in the levels of TNF-α, IL-1β and IL-8 compared with the radiation model group, ZSD group and added ingredients group (P <0.05 or P<0.01).

CONCLUSIONMZSD prevents the development of radiation esophagitis probably by inhibiting the generation and release of the inflammatory cytokines TNF-α, IL-1β and IL-8.

Animals ; Body Weight ; drug effects ; Cytokines ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Esophagitis ; drug therapy ; pathology ; prevention & control ; Esophagus ; drug effects ; pathology ; Feeding Behavior ; drug effects ; Inflammation Mediators ; metabolism ; Male ; Neutrophil Infiltration ; drug effects ; Radiation Injuries ; drug therapy ; pathology ; prevention & control ; Rats, Wistar ; Time Factors