| LV Dong-jie,WANG Lan,HAN Chun,et al.Toxicity analysis for esophagus in locally advanced non-small cell lung cancer(NSCLC) treatment using three dimensional conformal radiotherapy combined with concurrent chemotherapy[J].Chinese Journal of Radiological Medicine and Protection,2010,30(2):185-188 |
| Toxicity analysis for esophagus in locally advanced non-small cell lung cancer(NSCLC) treatment using three dimensional conformal radiotherapy combined with concurrent chemotherapy |
| Received:May 18, 2009 |
| DOI： |
| KeyWords:Lung neoplasm Conformal radiotherapy Chemotherapy Acute radiation esophagitis |
| FundProject:河北省普通高校强势特色学科课题(冀教高[2005]52号) |
| Author Name | Affiliation | E-mail | | LV Dong-jie | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhung 050011, China | | | WANG Lan | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhung 050011, China | | | HAN Chun | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhung 050011, China | hanchun2006@126.com | | GAO Chao | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhung 050011, China | | | LI Xiao-ning | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhung 050011, China | |
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| Abstract:: |
| Objective To investigate the radiation toxicity for esophagus in stage III NSCLC treatment using three dimensional conformal radiotherapy(3D CRT) combined with concurrent chemotherapy, and to obtain the relevant factors that can be regareded as predictors to complications of esophagus. Methods From Sep 2006 to Dec 2008, 52 patients with stage III NSCLC received 3D CRT plus concurrent chemotherapy of navelbine+cisplatin(NP) with prescription of 60 Gy/30 fractions, and chemotherapy at 1 and 5 week. Univariate and multivariate analysis and ROC(receiver operating characteristic curves) were performed to assess theassociation ofradiation-induced esophagitis and the correlated factors. Results Of all the patients, 84.6％(44/52) developed radiation esophagitis including grade 1 for 16 patients, grade 2 for 12 patients and grade 3 for 16 patients, without grade 4 developed. The correlative factors comprised of mean esophagus dose(MED), the LETT40, LETT45, LETT50, LETT55, LETT60, V40, V45, V50, V55 and V60 of esophagus according to Spearman correlative analysis, and all the 11 factors could predict radiation esophagitis according to univariate analysis(χ2=7.355-8.690, P＜0.05). Only V55 was found independently associated with esophagitis according to multivariate analysis. ROC analysis indicated that the cut-off point of the curve was 26% with the area under ROC curve of 0.725(P=0.006). For the patients with esophageal V55＞26%, 21 of 31(67.7%) developed 2 or 3 grade radiation esophagitis, while for the patients with V55≤26%, only 7 of 21(33.3%) developed severe esophagitis. Conclusions 3D CRT combined with concurrent chemotherapy for patients with stage III NSCLC may develop severe radiation esophagitis. Dosimetric parameters (MED, LETT40, LETT45, LETT50, LETT55, LETT60, V40, V45, V50, V55 and V60 ) were important to predict the radiation-induced esophagitis. According to multivariate analysis, V55 may be the most valuable predictor. When the value of V55 excluded 26%, the probability of esophagitis of grade 2 and 3 may increase notably. |
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