Factors Associated With Severe Acute Esophagitis From Hyperfractionated Radiotherapy With Concurrent Chemotherapy for Limited-Stage Small-Cell Lung Cancer

Journal Article · Wed Jul 15 04:00:00 EDT 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.09.013· OSTI ID:21276903

Watkins, John M ^[1]; Wahlquist, Amy E. M.S. ^[2]; Shirai, Keisuke ^[3]; Garrett-Mayer, Elizabeth ^[1]; Aguero, Eric G; Fortney, John A ^[1]; Sherman, Carol A ^[3]

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1. Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina (United States)
2. Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, South Carolina (United States)
3. Department of Medicine, Division of Hematology and Oncology, Medical University of South Carolina, Charleston, South Carolina (United States)

Purpose: To describe incidence and identify factors associated with development of severe acute esophagitis during hyperfractionated radiotherapy with concurrent chemotherapy (BID-CRT) in patients with limited-stage small-cell lung cancer (SCLC). Methods and Materials: Retrospective cohort analysis of patient-, tumor-, and treatment-related variables was performed to identify factors associated with Radiation Therapy Oncology Group (RTOG) Grade 3 acute esophagitis. Twice-daily chemoradiotherapy (BID-CRT) involved 45 Gy at 1.5 Gy per fraction, treated twice daily with concurrent platinum-based chemotherapy. Logistic regression analyses were used to identify factors associated with esophagitis. Results: Between June 1999 and June 2007, 48 patients underwent curative intent BID-CRT for SCLC and were included in the analysis. Median radiotherapy dose was 45 Gy (range, 42-51 Gy) delivered with a median 4 cycles of chemotherapy (range, 2-6). RTOG Grade 3 acute esophagitis developed in 11 patients. No patient developed Grade 4 or 5 esophagitis. Simple logistic regression analyses demonstrated a highly significant association between Grade 3 acute esophagitis and mean esophageal dose (p = 0.002) as well as relative volume dosimetric area under curve (RV-AUC; p = 0.004). Using multiple regression analysis, RV-AUC was identified as the only factor associated with Grade 3 esophagitis (p = 0.004). The most strongly associated dosimetric volume was the V15 (Grade 3 esophagitis rates of 15% vs. 64% for V15 <60% versus {>=}60%, respectively). Conclusions: RV-AUC is the factor most associated with development of Grade 3 acute esophagitis in limited stage SCLC patients receiving BID-CRT.

• OSTI ID: 21276903
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 74; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
COMBINED THERAPY
LUNGS
NEOPLASMS
PATIENTS
PLANNING
PLATINUM
RADIATION DOSES
RADIATION INJURIES
RADIOTHERAPY
REGRESSION ANALYSIS