NDLI: Management of normal tissue toxicity associated with chemoradiation (primary skin, esophagus, and lung).

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Management of normal tissue toxicity associated with chemoradiation (primary skin, esophagus, and lung).

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Yazbeck, Victor Y. Villaruz, Liza Haley, Marsha Socinski, Mark A.
Description	Country affiliation: United States Author Affiliation: Yazbeck VY ( Division of Hematology/Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA. yazbeckvy@upmc.edu)
Abstract	Nearly one quarter of patients with lung cancer present with locally advanced disease where concurrent chemoradiotherapy is the current standard of care for patients with good performance status. Cisplatin-based concurrent chemoradiotherapy consistently showed an improvement in survival compared with sequential chemoradiotherapy, at the expense of an increase in the toxicity profile. Over the past decades, several encouraging biomarkers such as transforming growth factor-beta and radioprotective agents such as amifostine were studied but without reaching approval for patient care. We reviewed the prevalence and risk factors for different adverse effects associated with the combined chemoradiotherapy modality, especially dermatitis, mucositis, esophagitis, and pneumonitis. These adverse effects can further be divided into acute, subacute, and chronic. Dermatitis is usually rare and responds well to topical steroids and usual skin care. Acute esophagitis occurs in 30% of patients and is treated with proton pump inhibitors, promotility agents, local anesthetic, and dietary changes. Radiation pneumonitis is a subacute complication seen in 15% of patients and is usually managed with steroids. Chronic adverse effects such as radiation fibrosis and esophageal stricture occur approximately 6 months after completion of radiation therapy and are usually permanent. In this review, complications of chemoradiotherapy for patients with locally advanced lung cancer are delineated, and approaches to their management are described. Given that treatment interruption is associated with a worse outcome, patients are aggressively treated with a curative intent. Therefore, planning for treatment adverse effects improves patient tolerance, compliance, and outcome.
File Format	HTM / HTML
ISSN	15289117
e-ISSN	1540336X
DOI	10.1097/PPO.0b013e31829453fb
Journal	The Cancer Journal
Issue Number	3
Volume Number	19
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2013-05-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Oncology Carcinoma, Non-small-cell Lung Therapy Esophagitis Lung Neoplasms Radiation Pneumonitis Radiodermatitis Animals Chemoradiotherapy Adverse Effects Etiology Pain Management Radiation Injuries Risk Factors Stomatitis Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Cancer Research Oncology

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Management of Normal Tissue Toxicity Associated With Chemoradiation (Primary Skin, Esophagus, and Lung)

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