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Radiation Oncology • Thoracic Malignancies
What is your first line strategy in managing acute esophagitis during thoracic RT?
I've been prescribing sucralfate as first line symptom management but I sometimes see zero benefit. The randomized data doesn't support its use either. What is a good first line strategy before going to narcotics?
Answer from: Radiation Oncologist at Academic Institution
Zombie Question (dead thread reanimated by theMednet)!!! The amount of esophagitis that I see in practice has really diminished over the course of my long, graying career. If you ever wanted to see a horrific esophagitis, treat a Turrisi regimen to those volumes. 60% of patients got Grade 2+ esophag...
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Answer from: Radiation Oncologist at Academic Institution
Diflucan 150 mg po weekly will make a big difference.
Comments
Radiation Oncologist at CARTI
I have often noted in many of my Head and neck and...
I have often noted in many of my Head and neck and...
Radiation Oncologist at UPMC Cancer Center
Extrapolate the clinical observation from H&N ...
Extrapolate the clinical observation from H&N ...
Radiation Oncologist at Mon Health
Has anyone found gabapentin helpful? If so, at wha...
Has anyone found gabapentin helpful? If so, at wha...
Radiation Oncologist at Vanderbilt-Ingram Cancer Center
There is some conflicting data for gabapentin in H...
There is some conflicting data for gabapentin in H...
Radiation Oncologist at Mallory Radiotherapy, PLLC
Anecdotally, I recently treated an oropharynx pati...
Anecdotally, I recently treated an oropharynx pati...
Radiation Oncologist at Mon Health
Thank you
Thank you
Radiation Oncologist at Wellspan Sechler Family Cancer Center
I have had great success with gabapentin for mucos...
I have had great success with gabapentin for mucos...
Radiation Oncologist at Mon Health
Thank you, what dose?
Thank you, what dose?
Answer from: Radiation Oncologist at Academic Institution
We typically begin with an institutional formulation (xyloxylin) that is similar to magic mouthwash. If that is not sufficient (and it frequently is not) then we begin narcotics, typically hydrocodone/APAP. If the patient is maximizing this regimen and taking it around the clock, then we treat with ...
Answer from: Radiation Oncologist at Academic Institution
We routinely offer patients amifostine (500 mg sc) prior to each fraction of RT (on non-chemotherapy days) as a method of prophylaxis. Our series suggests a postponement in the development of esophagitis (measured as initiation of opiate use) in patients treated using the cytoprotectant. O...