Prevention and management of treatment-induced pharyngo-oesophageal stricture

Eitan Prisman, Brett A. Miles, Eric M. Genden

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations


Pharyngo-oesophageal stricture (PES) is a serious complication that occurs in up to a third of patients treated with external beam radiotherapy or combined chemoradiotherapy for head and neck cancer. This entity is under-reported and as a result, our understanding of the pathophysiology and prevention of this complication is restricted. This Review presents the knowledge so far on radiation-related and non-radiation-related risk factors for PES, including tumour stage and subsite, patient age, and comorbidities. The interventions to decrease this toxicity are discussed, including early detection of PES, initiation of an oral diet, and protection of swallowing structures from high-dose radiation. We discuss various treatment options, including swallowing exercises and manoeuvres, endoscopic dilatations, and for advanced cases, oesophageal reconstruction. Study of the subset of patients who develop this toxicity and early recognition and intervention of this pathological change in future trials will help to optimise treatment of these patients.

Original languageEnglish
Pages (from-to)e380-e386
JournalThe Lancet Oncology
Issue number9
StatePublished - Aug 2013


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