BARRETT-ESOPHAGUS AFTER CHEMOTHERAPY WITH CYCLOPHOSPHAMIDE, METHOTREXATE, AND 5-FLUOROURACIL (CMF) - AN IATROGENIC INJURY

Methotrexate and 5-fluorouracil can provoke oral mucosal erosions and ulceration that may extend throughout the esophagus. This study was conducted to determine whether prolonged chemotherapy-induced esophageal damage may cause the development of Barrett esophagus. Sixteen women who had breast cancer and had been selected to receive at least six breast cancer and had been selected to receive at least six courses of chemotherapy with cyclophosphamide, methotrexate, and 5-flourouracil were included in the study. They had esophagoscopy, and several biopsy specimens were taken from the lower esophagus (3, 6, and 9 cm above the lower esophageal sphincter) before chemotherapy was begun and 1 month after the sixth course of chemotherapy. All patients had a normal esophagus at the first examination. After finishing chemotherapy, 10 (63%) had developed Barrett esophagus. One patient had the junctional type, 2 patients had the fundic type, 4 patients had a combination of the junctional and fundic types, and 3 patients had the intestinal type. These results suggest that chemotherapy-induced esophageal injury may have been responsible for the development of Barrett esophagus in our patients.