Gastrointestinal complications associated with radiation therapy--characteristic, confusing, or compounded.

Abstract

Symptoms resulting from radiation injury of the gastrointestinal tract are discussed and diagnostic techniques are outlined by reference to 13 cases. Gastrointestinal complications attributed to radiation most frequently follow intracavitary radium therapy in the treatment of cancer of the uterus. However, use of external radiation in treatment of certain types of urogenital carcinoma may also be associated with gastrointestinal complaints. As sources of radiation operating at supervoltage levels become more available, the ability to deliver higher depth doses may increase this problem. Small intestine is more susceptible to radiation injury than is the colon, but is less frequentiy the site of complications. The rectum and adjacent sigmoid colon more commonly are subject to radiation reactions because of their normal anatomic fixation and proximity to radium applicators used in the treatment of uterine cancer. The acute radiation gastrointestinal syndrome, occurring during or immediately after a course of radiation therapy, is described. Chronic or delayed symptoms are identified. Physical and endoscopic findings of ulceration, stricture, and induration frequently suggest recurrence of pelvic cancer, the incidence of which is markedly increased by previous surgical or inflammatory changes in the pelvis. (H.H.D.)