Exposure to Both Radiation and Chemotherapy Increases the Risk of Barrett’s and Multilayered Epithelium

Shields, Helen M.; Recht, Abram; Wang, Helen H.

doi:10.1007/s10620-008-0619-x

Cited by 4 publications

(4 citation statements)

References 36 publications

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“…These data are important given the well-known side effects of loco-regional, post-mastectomy radiotherapy [31–33]. Our findings have clear implications for the management of triple negative breast cancer patients with 1–3 or ≥ 4 positive lymph nodes.…”

Section: Discussionmentioning

confidence: 54%

Post-operative radiotherapy is beneficial for T1/T2 triple negative breast cancer patients with four or more positive lymph nodes

et al. 2017

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The efficacy of adjuvant radiotherapy for the treatment of triple negative breast cancer patients with varying numbers of positive lymph nodes is not clear. We assessed the association between adjuvant radiotherapy and survival in 943 T1/T2 triple negative breast cancer patients treated at our institute between 2008 and 2012. We determined that post-operative radiotherapy improved overall survival (OS), disease-free survival (DFS), and local recurrence-free survival (LRFS) in patients with ≥ 4 positive nodes (p = 0.037, p = 0.035, and p = 0.012, respectively). Although Cox regression analysis demonstrated that radiotherapy was a significant prognostic factor in triple negative breast cancer with ≥ 4 positive nodes, post-operative radiotherapy had no clear effect on OS, DFS, or LRFS in patients with 1-3 positive nodes (p = 0.849, p = 0.860, and p = 0.162, respectively). The prognosis (i.e., OS, DFS, and LRFS) of triple negative breast cancer patients without lymph node metastasis who underwent breast-conserving surgery and post-operative radiotherapy was similar to that of patients who underwent mastectomy alone (p = 0.336, p = 0.537, and p = 0.978, respectively). Our findings demonstrate that post-operative radiotherapy is beneficial for T1/T2 triple negative breast cancer patients with ≥ 4 positive lymph nodes.

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Section: Discussionmentioning

confidence: 54%

Post-operative radiotherapy is beneficial for T1/T2 triple negative breast cancer patients with four or more positive lymph nodes

et al. 2017

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“…Studies have reported the familial clustering of gastroesophageal reflux disease (GERD), BE, and EAC; however, we know little regarding the association between BE and personal or family history of cancer other than gastroesophageal. Studies investigating prior cancer treatments (radiation therapy and/or chemotherapy) and increased risk of BE/EAC have yielded conflicting results . To that end, using data from a large case‐control study among US veterans, we investigated the relationship between personal and family history of various types of cancer, as well as cancer treatments, and the risk of developing BE.…”

Section: Introductionmentioning

confidence: 99%

“…Studies investigating prior cancer treatments (radiation therapy and/or chemotherapy) and increased risk of BE/EAC have yielded conflicting results. [9][10][11][12][13][14][15][16][17][18][19][20] To that end, using data from a large case-control study among US veterans, we investigated the relationship between personal and family history of various types of cancer, as well as cancer treatments, and the risk of developing BE.…”

Section: Introductionmentioning

confidence: 99%

Personal and family history of cancer and the risk of Barrett's esophagus in men

et al. 2014

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The association between Barrett’s esophagus (BE) and a personal or family history of cancer other than gastroesophageal remains unknown. To evaluate the effect of personal and family history of certain cancers and cancer treatments on the risk of BE, we analyzed data from a Veterans Affairs case-control study that included 264 men with definitive BE (cases) and 1486 men without BE (controls). Patients with history of esophageal or gastric cancer were excluded. Patients underwent elective esophagogastroduodenoscopy (EGD) or a study EGD concurrently with screening colonoscopy to determine BE status. Personal and family history of several types of cancer was obtained from self-reported questionnaires, supplemented and verified by electronic medical-record reviews. We estimated the association between personal and family history of cancer or radiation/chemotherapy, and BE. Personal history of oropharyngeal cancer (1.5% vs. 0.4%) or prostate cancer (7.2% vs. 4.4%) was more frequently present in cases than controls. The association between BE and prostate cancer persisted in multivariable analyses (adjusted OR 1.90; 95% CI 1.07-3.38, P=0.028) while that with oropharyngeal cancer (adjusted OR 3.63; 95% CI 0.92-14.29, P=0.066) was attenuated after adjusting for retained covariates of age, race, GERD, hiatal hernia, and PPI use. Within the subset of patients with cancer, prior treatment with radiation or chemotherapy was not associated with BE. There were no significant differences between cases and controls in the proportions of subjects with several specific malignancies in first- or second-degree relatives. In conclusion, the risk of BE in men may be elevated with prior personal history of oropharyngeal or prostate cancer. However, prior cancer treatments and family history of cancer were not associated with increased risk of BE. Further studies are needed to elucidate if there is a causative relationship or shared risk factors between prostate cancer and BE.

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“…[7][8][9][10] Some studies have shown that such symptoms are common during MRT, particularly when given concurrently with (CT), but do not describe their incidence beyond 3 months after treatment, or the risk of late complications such as stricture, Barretts epithelium, and multilayered epithelium. [11][12][13][14][15][16][17][18][19] Our aim was to determine how often patients treated for breast cancer, lung cancer, or lymphoma have esophageal symptoms at baseline, how often such symptoms develop during treatment, and how often these symptoms persist 1 year after completion of therapy. We hypothesized that interventions such as proton pump inhibitors during or after treatment might reduce esophageal symptoms and evaluated each patients chart for use of these agents.…”

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confidence: 99%

Persistence of dysphagia and odynophagia after mediastinal radiation and chemotherapy in patients with lung cancer or lymphoma

Shields

Pelletier

et al. 2016

Diseases of the Esophagus

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Esophageal symptoms are common during radiation and chemotherapy. It is unclear how often these symptoms persist after therapy. We retrospectively reviewed medical records of 320 adults treated for nonmetastatic breast cancer (84), lung cancer (109), or Hodgkin and non-Hodgkin lymphoma (127) who were disease-free at 10-14 months after therapy. Treatment included chemotherapy with or without nonmediastinal radiation therapy (150 patients), chemotherapy plus sequential mediastinal radiation therapy (MRT) (48 patients), chemotherapy plus concurrent MRT (61 patients), or non-MRT only (61 patients). Proton pump inhibitor use was documented. All treatment groups had similar prevalence of the esophageal symptom of heartburn before therapy. Rates were higher during treatment in those who received MRT with or without chemotherapy, but declined by 10-14 months after treatment. However, low baseline rates of dysphagia (4%) and odynophagia (2%) increased significantly after combined chemotherapy and MRT to 72% for dysphagia and 62% for odynophagia (P < 0.01) during treatment and stayed significantly elevated over baseline with 27% of the patients having dysphagia and 11% having odynophagia at 10-14 months after treatment. The use of proton pump inhibitors by patients who had MRT with chemotherapy was significantly increased during and after treatment (P = 0.002). Dysphagia, odynophagia and the use of proton pump inhibitors were significantly more common both during and after treatment than before treatment in patients who received both chemotherapy and mediastinal radiation. Our data highlight the important challenge for clinicians of managing patients with lung cancer and lymphoma who have persistent esophageal problems, particularly dysphagia and odynophagia, at approximately 1 year after treatment.

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Exposure to Both Radiation and Chemotherapy Increases the Risk of Barrett’s and Multilayered Epithelium

Cited by 4 publications

References 36 publications

Post-operative radiotherapy is beneficial for T1/T2 triple negative breast cancer patients with four or more positive lymph nodes

Post-operative radiotherapy is beneficial for T1/T2 triple negative breast cancer patients with four or more positive lymph nodes

Personal and family history of cancer and the risk of Barrett's esophagus in men

Persistence of dysphagia and odynophagia after mediastinal radiation and chemotherapy in patients with lung cancer or lymphoma

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