Scintigraphic evaluation of oesophageal transit during radiotherapy to the mediastinum.
BACKGROUND
To quantitatively evaluate radiation-induced impaired oesophageal transit with oesophageal transit scintigraphy and to assess the relationships between acute oesophagitis symptoms and dysmotility.


METHODS
Between January 1996 and November 1998, 11 patients affected by non-small-cell carcinoma of the lung not directly involving the oesophagus, requiring adjuvant external beam radiotherapy (RT) to the mediastinum were enrolled. Oesophageal transit scans with liquid and semisolid bolus were performed at three pre-defined times: before (T0) and during radiation at 10 Gy (T1) and 30 Gy (T2). Two parameters were obtained for evaluation: 1) mean transit time (MTT); and 2) ratio between peak activity and residual activity at 40 seconds (ER-40s). Acute radiation toxicity was scored according to the joint EORTC-RTOG criteria. Mean values with standard deviation were calculated for all parameters. Analysis of variance (ANOVA) tests and paired t-Tests for all values were performed.


RESULTS
An increase in the ER-40s from T0 to T1 or T2 was seen in 9 of 11 patients (82%). The mean ER-40s value for all patients increased from 0.8306 (T0) to 0.8612 (T1) and 0.8658 (T2). These differences were statistically significant (p < 0.05) in two paired t-Tests at T0 versus T2 time: overall mean ER-40s and upright ER-40s (p = 0.041 and p = 0.032, respectively). Seven patients (63%) showed a slight increase in the mean MTT value during irradiation but no statistically significant differences in MTT parameters were found between T0, T1 and T2 (p > 0.05).


CONCLUSIONS
Using oesophageal scintigraphy we were able to detect early alterations of oesophageal transit during the third week of thoracic RT.
Sasso
Giuseppe
G
Radiation Oncology Department, Second University of Naples, Naples, Italy. giuseppesasso@tiscali.it
Rambaldi
Pierfrancesco
P
Sasso
Francesco S
FS
Cuccurullo
Vincenzo
V
Murino
Paola
P
Puntieri
Paolo
P
Marsiglia
Hugo R
HR
Mansi
Luigi
L
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy; D003679:Deglutition / Q000502:physiology* / Q000528:radiation effects; D015154:Esophageal Motility Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D004941:Esophagitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D004947:Esophagus / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000528:radiation effects; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy; D008297:Male; D008482:Mediastinum / Q000528:radiation effects*; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging / Q000379:methods; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D013997:Time Factors