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Ann Thorac Surg 2001;72:669
© 2001 The Society of Thoracic Surgeons

Correspondence

Radiation-induced secondary malignancy of the esophagus: Reply

Edward A. Levine, MDa

a Section of Surgical Oncology, Wake Forest University School of Medicine, Winston-Salem, NC, USA

To the Editor

In response to the comments from Dr Pollock, we would like to clarify a few items from our manuscript entitled, "Radiation induced gastrointestinal stromal sarcoma of the esophagus [1]." We are certainly in agreement that the incidence of radiation-induced/associated secondary malignancies is low, but, they by no means engender the majority of "treatment-related complications for therapeutic radiation." The analogy relating the risk of therapeutic radiation to general anesthesia is certainly an interesting one. However, the risk of mortality from an American Society of Anesthesiology class I or II patients is more likely to be 0.01% to 0.001% not the 1% implied by Dr Pollock [2, 3].

The intent of this manuscript was to highlight a potential complication of patients treated with radiation to the esophagus. The manuscript does not imply that radiation-induced/associated malignancy should be a significant factor in evaluating treatment options for esophageal carcinoma. In relation to Dr Pollock’s final comment, I would like to assure him that the patient found no reason to celebrate, and there was substantial reason for concern when she was found to have radiation-associated gastrointestinal stromal sarcoma in her heavily irradiated esophagus.

References

  1. Miller P.R., Jackson S.L., Pineau B.C., Levine E.A. Radiation- induced gastrointestinal stromal sarcoma of the esophagus. Ann Thorac Surg 2000;70:660-662.[Abstract/Free Full Text]
  2. Eichhorn J.H. Prevention of intraoperative anesthesia accidents and related severe injury through safety monitoring. Anesthesiology 1989;70:572.[Medline]
  3. Buck N., Devlin H.B., Lunn J.N. Report on the Confidential Inquiry into Perioperative Deaths. London: Nuffield Prevential Hospital’s Trust, LeKings Fund Publishing House, 1987.

Related Article

Radiation-induced secondary malignancy of the esophagus
Jondavid Pollock
Ann. Thorac. Surg. 2001 72: 669. [Extract] [Full Text] [PDF]




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