Advances in dosimetry and biological predictors of radiation-induced esophagitis

Abstract

ObjectiveTo summarize the research progress about the dosimetry and biological predictors of radiation-induced esophagitis.MethodsWe performed a systematic literature review addressing radiation esophagitis in the treatment of lung cancer published between January 2009 and May 2015 in the PubMed full-text database index systems.ResultsTwenty-eight eligible documents were included in the final analysis. Many clinical factors were related to the risk of radiation esophagitis, such as elder patients, concurrent chemoradiotherapy, and the intense radiotherapy regimen (hyperfractionated radiotherapy or stereotactic body radiotherapy). The parameters including Dmax, Dmean, V20, V30, V50, and V55 may be valuable in predicting the occurrence of radiation esophagitis in patients receiving concurrent chemoradiotherapy. Genetic variants in inflammation-related genes are also associated with radiation-induced toxicity.ConclusionDosimetry and biological factors of radiation-induced esophagitis provide clinical information to decrease its occurrence and grade during radiotherapy. More prospective studies are warranted to confirm their prediction efficacy.

Therapeutic effect of dental pulp stem cell transplantation on a rat model of radioactivity-induced esophageal injury

“…These changes induced dysphagia, odynophagia, and retrosternal pain. These symptoms and pathological changes are similar to those of acute clinical radioactive esophagitis 1 , 2 , 37 . 125 I seeds provide low doses of radiation that quickly decrease with increasing distance 38 .…”

“…Currently, chemoradiotherapy is the established standard treatment for locally advanced tumors of the head, neck, and lung. However, severe toxicities, such as acute radioactive esophageal injury, can develop within 3 weeks of radiation therapy and often cause unexpected complications 1 , 2 . Although natural radioprotectors are clinically used to prevent radiation injury, ionizing radiation injuries are not completely avoided 3 .…”

“…Although natural radioprotectors are clinically used to prevent radiation injury, ionizing radiation injuries are not completely avoided 3 . Repeated ionizing radiation causes dysphagia and odynophagia, which may lead to weight loss, when radiation dosages exceed 30 Gy 1 – 4 . Although acute radioactive esophageal injury is usually self-limited, severe esophageal injury can greatly lengthen the treatment period through additional hospitalization, esophageal ulceration, and clinical symptoms that include difficulty in swallowing, odynophagia, and substernal pain.…”