Fibrotic stricture

External beam radiation used as sole therapy or in combination with 5-fluorouracil (5 FU) can be used to relieve dysphagia in over two-thirds of patients with SCC. Symptoms recur, however, due to recurrent cancer or fibrotic strictures. The most effective chemotherapeutic regimen in advanced esophageal cancer is epirubicin, cisplatin, and continuous infusion of 5 FU. Two-thirds of cases respond with improvement of dysphagia. ... 

External radiotherapy provides sustained palliation in around 50% of patients. However, fibrotic strictures occur in 30% (Earlam and Cunha-Melo 1980). Chemotherapy has improved considerably in the last decade and now plays a useful role in palliation in some patients with advanced disease, resulting in some prolongation of life in 45% of patients (Webb et al. 1997), although the individual response to treatment remains unpredictable. The results of combined radio- and chemotherapy are better than either treatment alone, although toxicity is also increased. 

Fig. 7.2. a Post-radiotherapy fibrotic stricture (arrowhead), b A 5-mm balloon dilating the ureter... 

Fig. 19.7. Distal urethral stenosis studied with sonourethrography. Long stenosis of the bulbo-perineal urethra. The mucosa is hyperechoic with strong spots due to fibrotic strictures. The corpus spongiosum is thinned and hyperechoic due to chronic inflammation...

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