PURPOSE: To evaluate dose-volume histogram (DVH) parameters as predictors of radiation pneumonitis (RP) in esophageal cancer patients treated with definitive concurrent chemoradiotherapy. PATIENTS AND METHODS: Thirty-seven esophageal cancer patients treated with radiotherapy with concomitant chemotherapy consisting of 5-fluorouracil and cisplatin were reviewed. Radiotherapy was delivered at 2 Gy per fraction to a total of 60 Gy. For most of the patients, two weeks of interruption was scheduled after 30 Gy. The percentage of lung volume receiving more than 5-50 Gy in increments of 5 Gy (V5-V50, respectively), and the mean lung dose (MLD) were analyzed. RESULTS: Ten (27%) patients developed RP of grade 2; 2 (5%), grade 3; 0 (0%), grade 4; and 1 (3%), grade 5. By univariate analysis, all DVH parameters (i.e., V5-V50 and MLD) were significantly associated with grade 2 RP (p < 0.01). The incidences of grade 2 RP were 13%, 33%, and 78% in patients with V20s of 24%, 25-36%, and 37%, respectively. The optimal V20 threshold to predict symptomatic RP was 30.5% according to the receiver operating characteristics curve analysis. CONCLUSION: DVH parameters were predictors of symptomatic RP and should be considered in the evaluation of treatment planning for esophageal cancer. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
PURPOSE: To evaluate dose-volume histogram (DVH) parameters as predictors of radiation pneumonitis (RP) in esophageal cancerpatients treated with definitive concurrent chemoradiotherapy. PATIENTS AND METHODS: Thirty-seven esophageal cancerpatients treated with radiotherapy with concomitant chemotherapy consisting of 5-fluorouracil and cisplatin were reviewed. Radiotherapy was delivered at 2 Gy per fraction to a total of 60 Gy. For most of the patients, two weeks of interruption was scheduled after 30 Gy. The percentage of lung volume receiving more than 5-50 Gy in increments of 5 Gy (V5-V50, respectively), and the mean lung dose (MLD) were analyzed. RESULTS: Ten (27%) patients developed RP of grade 2; 2 (5%), grade 3; 0 (0%), grade 4; and 1 (3%), grade 5. By univariate analysis, all DVH parameters (i.e., V5-V50 and MLD) were significantly associated with grade 2 RP (p < 0.01). The incidences of grade 2 RP were 13%, 33%, and 78% in patients with V20s of 24%, 25-36%, and 37%, respectively. The optimal V20 threshold to predict symptomatic RP was 30.5% according to the receiver operating characteristics curve analysis. CONCLUSION: DVH parameters were predictors of symptomatic RP and should be considered in the evaluation of treatment planning for esophageal cancer. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
Authors: Matthew R McCurdy; Richard Castillo; Josue Martinez; Mohammad Najeeb Al Hallack; Jessica Lichter; Nicolas Zouain; Thomas Guerrero Journal: Radiother Oncol Date: 2012-05-10 Impact factor: 6.280
Authors: Yaqin Zhao; Lu Chen; Shu Zhang; Qiang Wu; Xiaoqin Jiang; Hong Zhu; Jin Wang; Zhiping Li; Yong Xu; Ying Jie Zhang; Sen Bai; Feng Xu Journal: Thorac Cancer Date: 2015-01-07 Impact factor: 3.500