International Journal of Radiation Oncology*Biology*Physics
Poster Viewing AbstractAnalysis of Predictive Factors for Acute Esophagitis in Lung Cancer Radiation Therapy
Section snippets
Purpose/Objective(s)
The purpose of this research is to identify dosimetric and clinical factors that predict acute esophagitis development in lung cancer radiation therapy patients. The V35 (the percentage volume of the esophagus receiving at least 35 Gy) and the V50 are believed to be accurate predictors of the development of acute esophagitis. The use of chemotherapy (particularly a taxane) is also hypothesized to increase the likelihood of esophagitis.
Materials/Methods
Patients receiving their first fractions of primary lung cancer radiation therapy during the years 2008-2012 at a single institution were queried. Queried patients who received less than 50 Gy to the tumor, fewer than 24 fractions, and simultaneous radiation therapy on different treatment plans were excluded. The presence or absence of acute esophagitis was recorded for the remaining 188 patients. Acute esophagitis was designated as present if the patient had grade 3 or higher esophagitis (by
Results
Of the 188 patients, 26 had grade 3 or higher acute esophagitis. Bivariate analysis revealed that for every 1% increase in V35, there was a 3% increase in the likelihood of acute esophagitis (P = 0.0220). For every 1% increase in V50, there was a 4% increase in the likelihood of acute esophagitis (P = 0.0031). Non-dosimetric factors (including chemotherapy) were not predictive of acute esophagitis in the bivariate or multivariate analyses. In a further exploratory analysis, concurrent use of a
Conclusion
The V35 and V50 were statistically significant predictors of grade 3 or greater acute esophagitis in lung cancer radiation therapy patients. Chemotherapy and other non-dosimetric factors were not predictive of acute esophagitis in the patient set, indicating that irradiation of the esophagus at the moderate and high isodose levels is likely the more important limiting factor when planning radiation therapy to prevent esophagitis.
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Author Disclosure: D.M. Harris: Review policy proposals to assess for scientific validity; organize medical student research symposium; AMA Medical Student Section, Committee on Scientific Issues. R.A. Popple: None. B.F. Jackson: None. K.P. Singh: None. J.A. Bonner: None. S.A. Spencer: None. M.C. Dobelbower: None. R.A. Shuford: None. J.B. Fiveash: Institution has research contracts with Varian; University of Alabama at Birmingham. Consulting; Varian.