PURPOSE: The purpose of this study was to investigate the dose-effect relation between acute esophageal toxicity (AET) and the dose-volume parameters of the esophagus after intensity modulated radiation therapy (IMRT) and concurrent chemotherapy for patients with non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: One hundred thirty-nine patients with inoperable NSCLC treated with IMRT and concurrent chemotherapy were prospectively analyzed. The fractionation scheme was 66 Gy in 24 fractions. All patients received concurrently a daily dose of cisplatin (6 mg/m(2)). Maximum AET was scored according to Common Toxicity Criteria 3.0. Dose-volume parameters V5 to V70, D(mean) and D(max) of the esophagus were calculated. A logistic regression analysis was performed to analyze the dose-effect relation between these parameters and grade ≥ 2 and grade ≥ 3 AET. The outcome was compared with the clinically used esophagus V35 prediction model for grade ≥ 2 after radical 3-dimensional conformal radiation therapy (3DCRT) treatment. RESULTS: In our patient group, 9% did not experience AET, and 31% experienced grade 1 AET, 38% grade 2 AET, and 22% grade 3 AET. The incidence of grade 2 and grade 3 AET was not different from that in patients treated with CCRT using 3DCRT. The V50 turned out to be the most significant dosimetric predictor for grade ≥ 3 AET (P=.012). The derived V50 model was shown to predict grade ≥ 2 AET significantly better than the clinical V35 model (P<.001). CONCLUSIONS: For NSCLC patients treated with IMRT and concurrent chemotherapy, the V50 was identified as most accurate predictor of grade ≥ 3 AET. There was no difference in the incidence of grade ≥ 2 AET between 3DCRT and IMRT in patients treated with concurrent chemoradiation therapy.
PURPOSE: The purpose of this study was to investigate the dose-effect relation between acute esophageal toxicity (AET) and the dose-volume parameters of the esophagus after intensity modulated radiation therapy (IMRT) and concurrent chemotherapy for patients with non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: One hundred thirty-nine patients with inoperable NSCLC treated with IMRT and concurrent chemotherapy were prospectively analyzed. The fractionation scheme was 66 Gy in 24 fractions. All patients received concurrently a daily dose of cisplatin (6 mg/m(2)). Maximum AET was scored according to Common Toxicity Criteria 3.0. Dose-volume parameters V5 to V70, D(mean) and D(max) of the esophagus were calculated. A logistic regression analysis was performed to analyze the dose-effect relation between these parameters and grade ≥ 2 and grade ≥ 3 AET. The outcome was compared with the clinically used esophagus V35 prediction model for grade ≥ 2 after radical 3-dimensional conformal radiation therapy (3DCRT) treatment. RESULTS: In our patient group, 9% did not experience AET, and 31% experienced grade 1 AET, 38% grade 2 AET, and 22% grade 3 AET. The incidence of grade 2 and grade 3 AET was not different from that in patients treated with CCRT using 3DCRT. The V50 turned out to be the most significant dosimetric predictor for grade ≥ 3 AET (P=.012). The derived V50 model was shown to predict grade ≥ 2 AET significantly better than the clinical V35 model (P<.001). CONCLUSIONS: For NSCLCpatients treated with IMRT and concurrent chemotherapy, the V50 was identified as most accurate predictor of grade ≥ 3 AET. There was no difference in the incidence of grade ≥ 2 AET between 3DCRT and IMRT in patients treated with concurrent chemoradiation therapy.
Authors: N Patrik Brodin; Rafi Kabarriti; Mark Pankuch; Clyde B Schechter; Vinai Gondi; Shalom Kalnicki; Chandan Guha; Madhur K Garg; Wolfgang A Tomé Journal: Int J Radiat Oncol Biol Phys Date: 2018-11-26 Impact factor: 7.038
Authors: Noëlle van der Voort van Zyp; Masoma Hashimzadah; Erik Kouwenhoven; Carmen Liskamp; Christa Gadellaa-van Hooijdonk; Ellen Pouw; Jose Belderbos; Klaartje Maas; Paul van de Vaart; Mirjam Mast Journal: Clin Transl Radiat Oncol Date: 2022-07-07