Alcohol as a potential contributing factor in radiation complications.

Various predisposing situations or conditions have been associated with a heightened risk of serious complications following therapeutic irradiation (XRT). Some examples include diabetes,1 ataxia telangiectasia,2 collagen vascular diseases such as scleroderma, lupus, or CREST syndrome (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia),3,4 or prior abdominal/pelvic surgeries5 when XRT is to be directed to the abdomen or pelvis. Malaise and colleagues suggested that various tumor types have inherently different radiosensitivities.6,7 A collaboration between a French group and an M.D. Anderson Cancer Center group indicated that there is an appreciable individual inherent difference in radiosensitivities for normal tissue cells.8 Peters and coworkers have examined a possible inherent sensitivity of head and neck squamous cell carcinomas by attempting to correlate radiation sensitivity of cultured tumor cells with response of the tumors in vivo. In principle, the in vitro radiation sensitivity of a given tumor could be used to adjust the final radiation dose to the individual head and neck cancer patient. There was a tendency for cells irradiated in vitro from patients who failed treatment to be more radioresistant, but the correlation was rather imperfect.9,10 We would suggest that radiation sensitivity of normal structures or tumors could be dependent on environmental or nutritional factors modifying the in vivo milieu, as well as inherent genetic factors. Oxygenation status has long been noted to influence the effect of radiation on tissues.2,10 We report and discuss here a case of serious complications following treatment for prostate cancer, in which a contributing factor would appear to be alcohol consumption.