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Radiation Oesophagitis — SCE Medical Oncology MCQ

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ModerateLung CancerRadiation OesophagitisSCE Medical Oncology

A 60-year-old man with NSCLC develops radiation oesophagitis grade 3 (dysphagia to liquids) during concurrent chemoradiotherapy. He is losing weight. What is the management?

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Correct answer: D — Supportive care: proton pump inhibitor, mucosal protectants (sucralfate), liquid diet/NG feeding if needed, pain management; consider treatment break only if clinically unsafe to continue

Radiation oesophagitis is the most common dose-limiting toxicity of thoracic radiotherapy, particularly with concurrent chemotherapy. Grade 3 (dysphagia to liquids/solids requiring supplemental nutrition) management includes: PPI, sucralfate suspension, viscous lidocaine, dietary modification (soft/liquid diet), and nasogastric/PEG feeding if oral intake is insufficient. Short treatment breaks may be necessary for grade 3-4 but should be minimised to avoid tumour repopulation. Most acute oesophagitis resolves 2-4 weeks after RT completion.

Reference: NICE NG122; ESMO 2024 Supportive Care; CTCAE v5.0