Radiation Pneumonitis after Intensity-Modulated Radiotherapy for Esophageal Cancer: Institutional Data and a Systematic Review.

Autor: Tonison JJ; Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany., Fischer SG; Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany., Viehrig M; Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany., Welz S; Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany., Boeke S; Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.; German Cancer Consortium (DKTK), Partner site Tübingen, Tübingen, Germany.; German Cancer Research Center (DKFZ), Heidelberg, Germany., Zwirner K; Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany., Klumpp B; Department of Diagnostic and Interventional Radiology, Eberhard Karls University Tübingen, Tübingen, Germany., Braun LH; Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany., Zips D; Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.; German Cancer Consortium (DKTK), Partner site Tübingen, Tübingen, Germany.; German Cancer Research Center (DKFZ), Heidelberg, Germany., Gani C; Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany. cihan.gani@med.uni-tuebingen.de.; Gastrointestinal Cancer Center, Comprehensive Cancer Center Tübingen-Stuttgart, Tübingen, Germany. cihan.gani@med.uni-tuebingen.de.; German Cancer Consortium (DKTK), Partner site Tübingen, Tübingen, Germany. cihan.gani@med.uni-tuebingen.de.; German Cancer Research Center (DKFZ), Heidelberg, Germany. cihan.gani@med.uni-tuebingen.de.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2019 Feb 19; Vol. 9 (1), pp. 2255. Date of Electronic Publication: 2019 Feb 19.
DOI: 10.1038/s41598-018-38414-5
Abstrakt: Radiation pneumonitis (RP) is a serious complication that can occur after thoracic radiotherapy. The goal of this study is to investigate the incidence of RP after radiochemotherapy with intensity modulated radiotherapy (IMRT) in patients with esophageal cancer and correlate this with dose volume histogram (DVH) related parameters. For this purpose, the clinical course of 73 patients was evaluated and irradiation doses to the lungs were extracted from radiotherapy treatment plans. Furthermore, a systematic review on this topic was conducted across PubMed. In our institutional cohort, Common Terminology Criteria for Adverse Events (CTCAE) grade II or higher RP occurred in four patients (5.5%). The systematic review identified 493 titles of which 19 studies reporting 874 patients qualified for the final analysis. No grade IV or V RP after radiochemotherapy with IMRT for esophageal cancer was reported in the screened literature. Grade II or higher RP is reported in 6.6% of the patients. A higher incidence can be seen with increasing values for lung V20. In conclusion, our institutional data and the literature consistently show a low incidence of symptomatic RP after radiochemotherapy in patients with esophageal cancer treated with IMRT. However, efforts should be made to keep the lung V20 below 23% and specific caution is warranted in patients with pre-existing lung conditions.
Databáze: MEDLINE
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