Factors Associated With Severe Acute Esophagitis From Hyperfractionated Radiotherapy With Concurrent Chemotherapy for Limited-Stage Small-Cell Lung Cancer
| Autor: | Anand K. Sharma, Keisuke Shirai, Amy E. Wahlquist, Carol A. Sherman, John A. Fortney, Elizabeth Garrett-Mayer, John M. Watkins, Eric G. Aguero |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Oncology Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Carboplatin Internal medicine Antineoplastic Combined Chemotherapy Protocols Esophagitis Humans Medicine Radiology Nuclear Medicine and imaging Lung cancer Aged Etoposide Retrospective Studies Acute Esophagitis Aged 80 and over Chemotherapy Radiation business.industry Incidence (epidemiology) Retrospective cohort study Middle Aged medicine.disease Combined Modality Therapy Small Cell Lung Carcinoma Radiation therapy Logistic Models Area Under Curve Acute Disease Female Dose Fractionation Radiation Cisplatin business Chemoradiotherapy |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 74:1108-1113 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2008.09.013 |
| Popis: | 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 Conclusions RV-AUC is the factor most associated with development of Grade 3 acute esophagitis in limited stage SCLC patients receiving BID-CRT. |
| Databáze: | OpenAIRE |
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