Onkológia 3/2023

Prevention and treatment of radiation-induced esophageal mucositis

Radiation-induced esophagitis is the most common local acute adverse effect of radiation therapy (RT) delivered with curative or palliative intent in the treatment of many head and neck, thoracic and abdominal malignancies. Combination of radiotherapy and chemotherapy and a higher dose of RT are associated with an increased risk of radiation esophagitis; however, advancement in RT techniques and adherence to esophageal dosimetric constraints may reduce its incidence and severity. Supportive management options include analgesics, suppression of gastric acid production, diet modification, treatment of esophageal candidiasis and maintenance of an adequate nutritional status. Esophageal stricture is the most common late sequela of esophageal irradiation and can be successfully addressed with endoscopic dilatation. In this review article, strategies to prevent or mitigate these common toxicities are discussed.

Keywords: radiation esophagitis, esophageal carcinoma, acute adverse effects, late adverse effects, stricture