title: [Esophageal toxicity of radiation therapy: clinical risk factors and management].
abstract: Acute radiation-induced esophagitis includes all clinical symptoms (odynophagia, dysphagia) occurring within 90 days after thoracic irradiation start. Its severity can be graded using RTOG and CTCAE scales. The clinical risk factors are: age, female gender, initial performance status, pre-therapeutic body mass index, pre-therapeutic dysphagia, tumoral and nodal stage, delivered dose, accelerated hyperfractionned radiotherapy, concomitant association of chemotherapy to radiotherapy and response to the treatment. The dosimetric parameters predictive of esophagitis are: mean dose, V(20Gy), V(30Gy), V(40Gy), V(45Gy) and V(50Gy). Amifostine is the only drug to have a proven radioprotective efficacy (evidence level C, ESMO recommendation grade III). The medical management of esophagitis associates a diet excluding irritant food, medication against gastroesophageal reflux, analgesic treatment according to the WHO scale and management of dehydration and denutrition by enteral feeding.
authors.affiliation: Département de radiothérapie et de physique médicale, QuantIF, Litis, centre Henri-Becquerel, Rouen, France. tanaclus@hotmail.com
authors.forename: T
authors.initials: T
authors.lastname: Challand
authors.forename: S
authors.initials: S
authors.lastname: Thureau
authors.forename: B
authors.initials: B
authors.lastname: Dubray
authors.forename: P
authors.initials: P
authors.lastname: Giraud
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D004032:Diet; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy; D004941:Esophagitis / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D011837:Radiation-Protective Agents / Q000627:therapeutic use; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000700:Analgesics; D054328:Proton Pump Inhibitors; D011837:Radiation-Protective Agents