Non-cancerous ulcer in the esophagus after radiotherapy for esophageal carcinoma — a report of 27 patients

Twenty-seven patients with non-cancerous ulcers (NCU) (radiation ulcer) after radiotherapy for esophageal carcinoma are presented. Two-thirds of them had been misdiagnosed as uncontrolled or recurrent cancers, leading to improper management. Patients with NCU in the esophagus are characterized by having severe pain in the chest or back, especially on swallowing. On X-ray films, the lesions appear as superficial ulcerations with a line of demarcation above and below the ulcer margin. The wall opposite the ulcer is not usually involved and the ulcer infrequently invades the nearby organs. On conservative treatment, they usually heal and the symptoms are relieved. Seven out of 27 patients have survived from 20 months to 13 years without any evidence of disease.