Abstract
Although the results of therapy for malignant tumors are now remarkably improved by virtue of the progress in radiotherapy, varying degree of injury to the gastrointestinal tract is unavoidable side effect of irradiation and cases requiring surgical treatment after the irradiation generally show poor prognosis. In the present study, 8 cases of radiation injury requiring surgical treatment, which were experienced by us during the past 10 years, were reviewed and analyzed. This series comprised 4 cases of bladder cancer, 3 cases of cancer of the uterine cervix and 1 case of penile cancer, with the average length of time elapsing from irradiation to surgery being 11.8 months. The prognosis was very poor in these 8 cases, with 5 of them had a fatal outcome in due course of time and 4 of these 5 died in operative mortality. In only one instance the peritoneal cavity was found infiltrated by malignant cells at operation. The reason for such an ominous prognosis was considered to be threefold: (1) The primary disease requiring radiotherapy was an advanced carcinoma and as the radiation injury being mistaken for recurrence of malignancy, there was a delay of operation. (2) The length of time elapsing from irradiation to the manifestation of injury was too long for the physician to keep the effects of radiation exposure in his mind. (3) Adhesions of the injured intestine and fragility of intestinal walls were of higher degree in cancer than in non-cancerous patients and this made operation more difficult to perform.
