Injurious effects of radiation on the esophagus

Esophageal damage secondary to radiation therapy to thoracic tumors is a major dose limiting complication. Concomitant use of chemotherapeutic agents enhance this problem which can appear as esophagitis early in the course of treatment or as strictures later. Early complications usually are treated conservatively, whereas endoscopic dilatations of the esophagus are often used for strictures. Newer developments in the field include use of arachidonic acid metabolism pathway inhibitors and radioprotectants. The use of these pharmacologicals, together with modification of the mechanics of radiation delivery, may lead us close to elimination of the complications in normal esophageal tissue, while enhancing localized response in the thoracic tumors.