Details

Autor(en) / Beteiligte

• Herr, Daniel J.
• Yin, Huiying
• Bergsma, Derek
• Dragovic, Aleksandar F.
• Matuszak, Martha
• Grubb, Margaret
• Dominello, Michael
• Movsas, Benjamin
• Kestin, Larry L.
• Boike, Thomas
• Bhatt, Amit
• Hayman, James A.
• Jolly, Shruti
• Schipper, Matthew
• Paximadis, Peter

Titel

Factors associated with acute esophagitis during radiation therapy for lung cancer

Ist Teil von

• Radiotherapy and oncology, 2024-08, Vol.197, p.110349, Article 110349

Ort / Verlag

Ireland: Elsevier B.V

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• •Analysis of predictors of acute esophagitis in 1760 patients treated for non-small cell lung cancer from 2012 to 2022.•Performance status, mean esophageal dose and D2cc are associated with development of both grade 2 + and grade 3 + acute esophagitis.•Concurrent chemotherapy is associated with grade 2 + acute esophagitis.•Mean esophageal dose of 29 Gy and esophageal D2cc of 61 Gy confer a 3 % risk of grade 3 + esophagitis. Limiting acute esophagitis remains a clinical challenge during the treatment of locally advanced non-small cell lung cancer (NSCLC). Demographic, dosimetric, and acute toxicity data were prospectively collected for patients undergoing definitive radiation therapy +/- chemotherapy for stage II-III NSCLC from 2012 to 2022 across a statewide consortium. Logistic regression models were used to characterize the risk of grade 2 + and 3 + esophagitis as a function of dosimetric and clinical covariates. Multivariate regression models were fitted to predict the 50 % risk of grade 2 esophagitis and 3 % risk of grade 3 esophagitis. Of 1760 patients, 84.2 % had stage III disease and 85.3 % received concurrent chemotherapy. 79.2 % of patients had an ECOG performance status ≤ 1. Overall rates of acute grade 2 + and 3 + esophagitis were 48.4 % and 2.2 %, respectively. On multivariate analyses, performance status, mean esophageal dose (MED) and minimum dose to the 2 cc of esophagus receiving the highest dose (D2cc) were significantly associated with grade 2 + and 3 + esophagitis. Concurrent chemotherapy was associated with grade 2 + but not grade 3 + esophagitis. For all patients, MED of 29 Gy and D2cc of 61 Gy corresponded to a 3 % risk of acute grade 3 + esophagitis. For patients receiving chemotherapy, MED of 22 Gy and D2cc of 50 Gy corresponded to a 50 % risk of acute grade 2 + esophagitis. Performance status, concurrent chemotherapy, MED and D2cc are associated with acute esophagitis during definitive treatment of NSCLC. Models that quantitatively account for these factors can be useful in individualizing radiation plans.