Dose-volumetric parameters and prediction of severe acute esophagitis in patients with locally-advanced non small-cell lung cancer treated with neoadjuvant concurrent hyperfractionated-accelerated chemoradiotherapy

Manapov, Farkhad; Sepe, Susanna; Niyazi, Maximilian; Belka, Claus; Friedel, Godehard und Budach, Wilfried (2013): Dose-volumetric parameters and prediction of severe acute esophagitis in patients with locally-advanced non small-cell lung cancer treated with neoadjuvant concurrent hyperfractionated-accelerated chemoradiotherapy. In: Radiation Oncology 8:122

Abstract

Background: To identify dose-volume parameters predictive for severity of acute esophagitis (CTC > grade 2) in locally-advanced non small-cell lung cancer (LA-NSCLC) patients treated with neoadjuvant concurrent hyperfractionated-accelerated chemoradiotherapy (HA-CRT) a retrospective analysis was performed. 88 patients were treated with HA-CRT followed by radical surgery. Predictive power of absolute oesophageal length, absolute and relative oesophageal volume included in the 95\%-isodose, patient-and tumor-related factors for severity of acute esophagitis was assessed. Findings: A total of 82 patients (93\%) developed radiation-induced acute esophagitis. Grade 1 was documented in 1 (1\%), grade 2 in 55 (67\%), grade 3 in 23 (28\%) and grade 4 in 3 (4\%) patients, respectively. Absolute oesophageal volume included in the 95\%-isodose (42.8 Gy) achieved 13.5 cm(3) (range: 3 - 29 cm(3)). Of the tested variables in univariate analysis, absolute oesophageal volume included in the 95\%-Isodose was found to be the only significant variable (p = 0.03) predicting severe acute esophagitis (CTC > grade 2). For this volume a gradation scale of the likelihood of severity was built. Conclusion: Increase of absolute oesophageal volume included in the 95\%-isodose correlates with severity of acute esophagitis in LA-NSCLC patients treated with neo-adjuvant concurrent HA-CRT.

• Item Type: Journal article
• Form of publication: Publisher's Version
• Faculties: Medicine
• Subjects: 600 Technology > 610 Medicine and health
• ISSN: 1748-717X
• Language: English