AI Chat Paper
Note: Please note that the following content is generated by AMiner AI. SciOpen does not take any responsibility related to this content.
{{lang === 'zh_CN' ? '文章概述' : 'Summary'}}
{{lang === 'en_US' ? '中' : 'Eng'}}
Chat more with AI
Powered by AMiner. Clicking this button will take you away from SciOpen.
Home Precision Radiation Oncology Article
Article Link
Cite
EndNote(RIS) BibTeX
Collect
Show Outline
Outline
Show full outline
Hide outline
Outline
Show full outline
Hide outline
Clinical Guideline | Open Access

Chinese clinical practice guidelines for the prevention and treatment of radiation-induced esophagitis

Congrong Yang1, Jun Wang1,2,3 ( ), Shuanghu Yuan2,4,5 ( )
Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University
Chinese Radiation Therapy Oncology Group
China Anti-Cancer Association Tumor Radiation Protection Committee
China Anti-Cancer Association Tumor Support Therapy Committee
Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
Show Author Information

Abstract

Acute radiation-induced esophagitis is a common complication of radiotherapy for esophageal, lung, and other malignancies. Therefore, understanding the diagnosis, grading, risk factors, prevention, and treatment of radiation-induced esophagitis is essential. Currently, there are few consensuses and guidelines on radiation-induced esophagitis worldwide, mainly the American College of Gastroenterology (ACG) clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE) and the Digestive Endoscopy Society of Chinese Medical Association’s “Guidelines for the Diagnosis and Treatment of Reflux Esophagitis.” However, no consensus or guidelines specifically addressing radiation-induced esophagitis have been established. Efforts have been made to organize experts to draft Chinese consensus or guidelines, but the recommendations in these guidelines also vary owing to differences in expert backgrounds. The clinical practice guidelines presented herein were developed for the first time with the joint participation of Chinese radiotherapy experts. Drugs and methods with clinical significance were selected by reviewing and summarizing the prevention and treatment of radiation-induced esophagitis and combining them with China’s national conditions. After multiple rounds of discussion and revision, clinical practice guidelines were established in line with the needs of Chinese clinicians, providing useful clinical guidance for the prevention and treatment of radiation-induced esophagitis.

Keywords

radiotherapyclinical practice guidelinesadverse reaction managementradiation-induced esophagitis

References

1

Shen W, Wang L. Radiation therapy for injury. Beijing: China: Medical Science and Technology Press; 2001: 115.
2

Coia LR, Myerson RJ, Tepper JE. Late effects of radiation therapy on the gastrointestinal tract. Int J Radiat Oncol Biol Phys. 1995;31(5): 1213-1236.
Crossref Google Scholar
3

Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995;31(5): 1341-1346.
Crossref Google Scholar
4

Bradley JD, Paulus R, Komaki R, et al. Standard-dose versus high-dose conformal radiotherapy with concurrent and consolidation carboplatin plus paclitaxel with or without cetuximab for patients with stage ⅢA or ⅢB non-small-cell lung cancer (RTOG 0617): a randomized, two-by-two factorial phase 3 study. Lancet Oncol. 2015;16(2): 187-199.
Crossref Google Scholar
5

Gu T, Hua HX, Fu ZZ, et al. [Multi-factor analysis of radiation-induced esophagitis in three-dimensional conformal radiotherapy for non-small cell lung cancer]. Chin J Oncol. 2011;33(11): 868-871. D: 22335956.
Google Scholar
6

Maguire PD, Sibley GS, Zhou SM, et al. Clinical and dosimetric predictors of radiation-induced esophageal toxicity. Int J Radiat Oncol Biol Phys. 1999;45(1): 97-103.
Crossref Google Scholar
7

Caglar HB, Othus M, Allen AM. Esophagus in-field: a new predictor for esophagitis. Radiother Oncol. 2010;97(1): 48-53.
Crossref Google Scholar
8

Rosenman JG, Halle JS, Socinski MA, et al. High-dose conformal radiotherapy for treatment of stage ⅢA/ⅢB non-small-cell lung cancer: technical issues and results of a phase Ⅰ/Ⅱ trial. Int J Radiat Oncol Biol Phys. 2002;54(2): 348-356.
Crossref Google Scholar
9

Palma DA, Senan S, Oberije C, et al. Predicting esophagitis after chemoradiation therapy for non-small cell lung cancer: an individual patient data meta-analysis. Int J Radiat Oncol Biol Phys. 2013;87(4): 690-696.
Crossref Google Scholar
10

Rose J, Rodrigues G, Yaremko B, et al. Systematic review of dose-volume parameters in the prediction of esophagitis in thoracic radiotherapy. Radiother Oncol. 2009;91(3): 282-287.
Crossref Google Scholar
11

Watkins JM, Wahlquist AE, Shirai K, et al. Factors associated with severe acute esophagitis from hyperfractionated radiotherapy with concurrent chemotherapy for limited-stage small-cell lung cancer. Int J Radiat Oncol. 2009;74(4): 1108-1113.
Crossref Google Scholar
12

Grant JD, Shirvani SM, Tang C, et al. Incidence and predictors of severe acute esophagitis and subsequent esophageal structure in patients treated with accelerated hyperfractionated chemoradiation for limited-stage small cell lung cancer. Pract Radiat Oncol. 2015;5(4): e383-e391.
Crossref Google Scholar
13

Gomez DR, Tucker SL, Martel MK, et al. Predictors of high-grade esophagitis after definitive three-dimensional conformal therapy, intensity-modulated radiation therapy, or proton beam therapy for non-small cell lung cancer. Int J Radiat Oncol Biol Phys. 2012;84(4): 1010-1016.
Crossref Google Scholar
14
Li C, Wang L, Wu Q, et al. A meta-analysis comparing stereotactic body radiotherapy vs conventional radiotherapy in inoperable stage Ⅰ non-small cell lung cancer. Medicine (Baltimore). 2020;99(34): e21715[2023-01-11]. https://pubmed.ncbi.nlm.nih.gov/32846789/. doi: 10.1097/MD.0000000000021715
Crossref
15

Park HS, Harder EM, Mancini BR, et al. Central versus peripheral tumor location: influence on survival, local control, and toxicity following stereotactic body radiotherapy for primary non-small-cell lung cancer. J Thorac Oncol. 2015;10(5):832-837.
Crossref Google Scholar
16

Mangona VS, Aneese AM, Marina O, et al. Toxicity after central versus peripheral lung stereotactic body radiation therapy:a propensity score matched-pair analysis. Int J Radiat Oncol Biol Phys. 2015;91(1):124-132.
Crossref Google Scholar
17

Sainathan S, Wu LD, Andaz S. Delayed esophageal perforation from stereotactic body radiation therapy for locally recurrent central non-small cell lung cancer. Lung India. 2014;31(2):158-160.
Crossref Google Scholar
18

Loi M, Franceschini D, Dominici L, et al. Stereotactic radiotherapy for ultra-central lung oligometastases in non-small-cell lung cancer. Cancers (Basel). 2020;12(4):885.
Crossref Google Scholar
19

Bar-Ad V, Leiby B, Witek M, et al. Treatment-related acute esophagitis for patients with locoregionally advanced non-small cell lung cancer treated with involved-field radiotherapy and concurrent chemotherapy. Am J Clin Oncol. 2014;37(5):433-437.
Crossref Google Scholar
20

Curran WJ Jr, Paulus R, Langer CJ, et al. Sequential vs. concurrent chemoradiation for stage Ⅲ non-small cell lung cancer: randomized phase Ⅲ trial RTOG 9410. J Natl Cancer Inst. 2011;103(19):1452-1460.
Crossref Google Scholar
21

Ball D, Bishop J, Smith J, et al. A randomized phase Ⅲ study of accelerated or standard fraction radiotherapy with or without concurrent carboplatin in inoperable non-small cell lung cancer: final report of an Australian multi-centre trial. Radiother Oncol. 1999;52(2):129-136.
Crossref Google Scholar
22

Manapov F, Sepe S, Niyazi M, et al. Dose-volumetric parameters and prediction of severe acute esophagitis in patients with locally-advanced non small-cell lung cancer treated with neoadjuvant concurrent hyperfractionated-accelerated chemo-radiotherapy. Radiat Oncol. 2013;8:122.
Crossref Google Scholar
23

Oral EN, Bavbek S, Kizir A, et al. Preliminary analysis of a phase Ⅱ study of Paclitaxel and CHART in locally advanced non-small cell lung cancer. Lung Cancer. 1999;25(3):191-198.
Crossref Google Scholar
24

Byhardt RW, Scott C, Sause WT, et al. Response, toxicity, failure patterns, and survival in five Radiation Therapy Oncology Group (RTOG) trials of sequential and/or concurrent chemotherapy and radiotherapy for locally advanced non-small-cell carcinoma of the lung. Int J Radiat Oncol Biol Phys. 1998;42(3):469-478.
Crossref Google Scholar
25

Choy H, Laporte K, Knill-Selby E, et al. Esophagitis in combined modality therapy for locally advanced non-small cell lung cancer. Semin Radiat Oncol. 1999;9(2 Suppl 1):90-96.
Google Scholar
26

Komaki R, Seiferheld W, Ettinger D, et al. Randomized phase Ⅱ chemotherapy and radiotherapy trial for patients with locally advanced inoperable non-small-cell lung cancer: long-term follow-up of RTOG 92-04. Int J Radiat Oncol Biol Phys. 2002;53(3):548-557.
Crossref Google Scholar
27

Socinski m A, Zhang C, Herndon JE 2nd, et al. Combined modality trials of the cancer and leukemia group B in stage Ⅲ non-small-cell lung cancer: analysis of factors influencing survival and toxicity. Ann Oncol. 2004;15(7):1033-1041.
Crossref Google Scholar
28

Belderbos J, Heemsbergen W, Hoogeman M, et al. Acute esophageal toxicity in non-small cell lung cancer patients after high dose conformal radiotherapy. Radiother Oncol,2005,75(2):157–164.
Crossref Google Scholar
29

Werner-Wasik M, Pequignot E, Leeper D, et al. Predictors of severe esophagitis include use of concurrent chemotherapy, but not the length of irradiated esophagus:a multivariate analysis of patients with lung cancer treated with nonoperative therapy. Int J Radiat Oncol Biol Phys. 2000;48(3):689-696.
Crossref Google Scholar
30

Auperin A, Le Pechoux C, Rolland E, et al. Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol. 2010;28(13):2181-2190.
Crossref Google Scholar
31

Vokes EE, Herndon JE 2nd, Crawford J, et al. Randomized phase Ⅱ study of cisplatin with gemcitabine or paclitaxel or vinorelbine as induction chemotherapy followed by concomitant chemo-radiotherapy for stage ⅢB non-small-cell lung cancer: cancer and leukemia group B study 9431. J Clin Oncol. 2002;20(20):4191-4198.
Crossref Google Scholar
32

Hirose T, Mizutani Y, Ohmori T, et al. The combination of cisplatin and vinorelbine with concurrent thoracic radiation therapy for locally advanced stage ⅢA or ⅢB non-small-cell lung cancer. Cancer Chemother Pharmacol. 2006;58(3):361-367.
Crossref Google Scholar
33

Sekine I, Noda K, Oshita F, et al. Phase Ⅰ study of cisplatin, vinorelbine, and concurrent thoracic radiotherapy for unresectable stage Ⅲ non-small cell lung cancer. Cancer Sci. 2004;95(8):691-695.
Crossref Google Scholar
34

Safran H, Suntharalingam M, Dipetrillo T, et al. Cetuximab with concurrent chemoradiation for esophagogastric cancer:assessment of toxicity. Int J Radiat Oncol Biol Phys. 2008;70(2):391-395.
Crossref Google Scholar
35

Von Reibnitz D, Chaft JE, Wu AJ, et al. Safety of combining thoracic radiation therapy with concurrent versus sequential immune checkpoint inhibition. Adv Radiat Oncol. 2018;3(3):391-398.
Crossref Google Scholar
36

Zhang W, Yan C, Zhang T, et al. Addition of camrelizumab to docetaxel, cisplatin, and radiation therapy in patients with locally advanced esophageal squamous cell carcinoma: a phase 1b study. Oncoimmunology. 2021;10(1):1971418. doi:10.1080/2162402X.2021.1971418
Crossref Google Scholar
37

Diamond BH, Verma N, Shukla UC, et al. Consolidative thoracic radiation therapy after first-line chemotherapy and immunotherapy in extensive-stage small cell lung cancer:a multi-institutional case series. Adv Radiat Oncol. 2022;7(2):100883. doi:10.1016/j.adro.2021.100883
Crossref Google Scholar
38

Wang L, Wang J, Yu B, et al. Analysis of side effects and prognosis of radiotherapy alone in treatment of senile esophageal cancer. Chin J Cancer Prev Treat. 2018;25(23):1638-1642.
Google Scholar
39

Liu H, Wang J, Dai S, et al. Risk factors for radiation esophagitis and pneumonitis in esophageal cancer patients with diabetes or hypertension. Chin J Radiol Med Prot. 2018;38(8):584-589.
Google Scholar
40

Wada K, Kishi N, Kanayama N, et al. Predictors of acute radiation esophagitis in non-small cell lung cancer patients treated with accelerated hyperfractionated chemoradiotherapy. Anti-cancer Res. 2019;39(1):491-497.
Crossref Google Scholar
41

Everitt S, Duffy M, Bressel M, et al. Association of oesophageal radiation dose volume metrics, neutropenia and acute radiation oesophagitis in patients receiving chemo-radiotherapy for non-small cell lung cancer. Radiat Oncol. 2016;11:20.
Crossref Google Scholar
42

De Ruysscher D, Dehing C, Bremer RH, et al. Maximal neutropenia during chemotherapy and radiotherapy is significantly associated with the development of acute radiation-induced dysphagia in lung cancer patients. Ann Oncol. 2007;18(5):909-916.
Crossref Google Scholar
43

Tang C, Liao Z, Zhuang Y, et al. Acute phase response before treatment predicts radiation esophagitis in non-small cell lung cancer. Radiother Oncol. 2014;110(3):493-498.
Crossref Google Scholar
44

Leigh BR, Lau DH. Severe esophageal toxicity after thoracic radiation therapy for lung cancer associated with the human immunodeficiency virus:a case report and review of the literature. Am J Clin Oncol. 1998;21(5):479-481.
Crossref Google Scholar
45

Costleigh BJ, Miyamoto CT, Micaily B, et al. Heightened sensitivity of the esophagus to radiation in a patient with AIDS. Am J Gastroenterol. 1995;90(5):812-814.
Google Scholar
46

Dong J, Zhang W, Zhang T, et al. Baseline nutritional status could be a predictor for radiation esophagitis in esophageal cancer patients undergoing radiotherapy. Ann Transl Med. 2020;8(18):1148.
Crossref Google Scholar
47

Lu J,Li T,Xie C,et al. Expert consensus on enteral nutrition for patients undergoing radiotherapy for esophageal cancer. Electron J Metab Nutr Cancer. 2015;4(4):29-32.
Google Scholar
48

Koc M, Onuk MD, Koruk M, et al. Therapeutic effect of oral recombinant human granulocyte macrophage-colony stimulating factor in radiotherapy-induced esophagitis. Hepatogastroenterology. 2003;50(53):1297-1300.
Google Scholar
49

Lu JZ, Wang C, Yang MH, et al. Effect of modified Zhuye Shigao Decoction and its components on preventing radiation esophagitis of rats. Chin J Integr Med. 2014;20(6):462-467.
Crossref Google Scholar
50

Wang Z, Shen L, Wang J, et al. Immunostimulatory effect of a composition isolated from white peony root oral liquid in the treatment of radiation-induced esophagitis. Exp Ther Med. 2013;6(4):1010-1014.
Crossref Google Scholar
51

Li XH, Hu Y, Yang H, et al. A new retrievable nitinol alloy stents for treatment of refractory benign esophageal strictures. Chin J Gastrointest Surg. 2011;14(11):875-878.
Google Scholar
52

Antonadou D, Coliarakis N, Synodinou M, et al. Randomized phase Ⅲ trial of radiation treatment +/- amifostine in patients with advanced-stage lung cancer. Int J Radiat Oncol Biol Phys. 2001;51(4):915-922.
Crossref Google Scholar
53

Xu J, Deng X, Peng J, et al. GM-CSF mouthwashes in the prevention of radiation-induced esophagitis: A randomized,controlled study. J Mod Oncol. 2017;25(17):2737-2740.
Google Scholar
54

Topkan E, Yavuz MN, Onal C, et al. Prevention of acute radiation-induced esophagitis with glutamine in non-small cell lung cancer patients treated with radiotherapy: evaluation of clinical and dosimetric parameters. Lung Cancer. 2009;63(3):393-399.
Crossref Google Scholar
55

Zhang Z, Xu J, Zhou T, et al. Risk factors of radiation-induced acute esophagitis in non-small cell lung cancer patients treated with concomitant chemoradiotherapy. Radiat Oncol, 2014;9:54.
Crossref Google Scholar
Precision Radiation Oncology
Volume 7 Issue 4,
December 2023
Pages 225-236
DOI: 10.1002/pro6.1210
Cite this article:
Yang C, Wang J, Yuan S. Chinese clinical practice guidelines for the prevention and treatment of radiation-induced esophagitis. Precision Radiation Oncology, 2023, 7(4): 225-236. https://doi.org/10.1002/pro6.1210

151

Views

0

Crossref

0

Scopus

Altmetrics
Received: 09 July 2023
Revised: 26 August 2023
Accepted: 27 August 2023
Published: 20 December 2023
© 2023 The Authors.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Return