RADIATION INDUCED CHRONIC GI INJURY – OUR INSTITUTE EXPERIENCE

Abstract

Background: Early and late GIgastrointestinal injury may occur following irradiation of thoracic, abdominal, and pelvic malignancies, which limits radiation doses that can be delivered as well as causing significant morbidity requiring intervention. We analysed the injury with respect to spectrum of injury, severity, morbidity and treatment required. Methods: Patients with chronic radiation injury defined as illness presenting after 3 months of radiation treatment were included in the study. The study period was two years. Results: Total number of patients studied were 53. Stricture esophagus was the most common injury, others being radiation proctocolitis, stricture cricopharynx, partial gastric outlet obstruction, radiation duodenitis, small bowel obstruction, jejunal ulceration, colovesical fistula and anal canal stricture. Endoscopic treatment was required in 75% patients. Surgery was required in 9.4% patients. Conclusion: Chronic radiation injury causes significant morbidity requiring prolonged treatment and hospitalization. Dose and duration of radiation had direct relation to the severity of injury. Concurrent chemotherapy had no effect on severity of chronic GI injury. Majority of reported forms of chronic injury required repeated endoscopic treatment. Response to treatment was not related to endoscopic or clinical severity of injury or dose of radiation given.