Pharmacological and dietary prophylaxis and treatment of acute actinic esophagitis during mediastinal radiotherapy

Our purpose was to evaluate a pharmacological and dietary protocol of proph ylaxis and treatment of acute actinic esophagitis during mediastinal radiot herapy. This phase II study was conducted on 29 patients affected by cancer not directly involving the esophagus. The irradiated volume included at le ast 10 cm of esophagus with a median dose of 46 Gy and the incidence of cli nical acute esophagitis was scored with RTOG-EORTC tables. During the entir e course of radiation therapy all patients were subjected to prophylaxis ph armacological therapy in addition to dietetic rules commonly used. All pati ents were evaluable, 9 (31%) had no acute esophageal toxicity, 20 (69%) had toxicity of degree 1, and no patient showed a toxicity of degree 2, 3, or 4, there were no toxicity-related related interruptions of the radiotherapy course. In conclusion, this low cost protocol seems to reduce the incidenc e and degree of acute radiation esophagitis (without added morbidity), comp ared with literature reports.