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Severe late esophagus toxicity in NSCLC patients treated with IMRT and concurrent chemotherapy.

Chun Chen ,
Wilma Uyterlinde ,
Jan-Jakob Sonke ,
Josien de Bois ,
Michel van den Heuvel ,
José Belderbos

Abstract

MATERIAL AND METHODS

Two hundred and thirty-one patients treated from 2008 to 2011 with hypofractionated IMRT (66Gy/24fx) and concurrent daily low dose cisplatin were included. The association between AET and severe LET (grade ≥ 3 RTOG/EORTC) was tested through Cox-proportional-hazards model. Equivalent uniform dose (EUD) to the esophagus and the volume percentage receiving more than x Gy (Vx) were applied by Lyman-Kutcher-Burman (LKB) model.

CONCLUSIONS

Severe AET, EUD (n=0.03) and V76.7 to the esophagus were significantly associated with severe LET. An independent validation study is required.

RESULTS

A total of 171 patients were eligible for this study. Severe LET was observed in 6% patients. Both the maximum grade and the recovery rate of AET were significantly associated with severe LET. In the EUDn-LKB model, the fitted values and 95% confidence intervals (CIs) were TD50=76.1 Gy (73.2-78.6), m=0.03 (0.02-0.06) and n=0.03 (0-0.08). In the Vx-LKB model, the fitted values and 95% CIs were Tx50=23.5% (16.4-46.6), m=0.44 (0.32-0.60) and x=76.7 Gy (74.7-77.5).

BACKGROUND AND PURPOSE

We reported the incidence of severe late esophagus toxicity (LET) in locally advanced NSCLC patients treated with intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy. Acute esophagus toxicity (AET) and the dose to the esophagus were analyzed for their associations with severe LET.

More about this publication

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

Volume 108
Issue nr. 2
Pages 337-41
Publication date 01-08-2013

Full text links

Publisher website (DOI) 10.1016/j.radonc.2013.08.017
Europe PubMed Central 24074814
Pubmed 24074814

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