Liu Huilan,Wang Jianlin,Dai Shengbin,et al.Risk factors for radiation esophagitis and pneumonitis in esophageal cancer patients with diabetes or hypertension[J].Chinese Journal of Radiological Medicine and Protection,2018,38(8):584-589
Risk factors for radiation esophagitis and pneumonitis in esophageal cancer patients with diabetes or hypertension
Received:January 18, 2018  
DOI:10.3760/cma.j.issn.0254-5098.2018.08.005
KeyWords:Diabetes  Hypertension  Esophageal cancer  Radiation esophagitis  Radiation pneumonitis
FundProject:国家自然科学基金(11705095)
Author NameAffiliationE-mail
Liu Huilan Department of Tumor, Taizhou People's Hospital, Taizhou 225300, China  
Wang Jianlin Department of Radiotherapy, Changzhou Second People's Hospital, Affiliated Hospital of Nanjing Medical University, Changzhou 213001, China  
Dai Shengbin Department of Tumor, Taizhou People's Hospital, Taizhou 225300, China  
Yu Bo Department of Radiotherapy, Jiangyin People's Hospital, Jiangyin 214400, China  
Sha Sha Department of Radiotherapy, Jiangyin People's Hospital, Jiangyin 214400, China  
Shu Zhongqin Department of Radiotherapy, Jiangyin People's Hospital, Jiangyin 214400, China  
Gu Xiaowei Department of Radiotherapy, Jiangyin People's Hospital, Jiangyin 214400, China  
Wang Jian Department of Radiotherapy, Changzhou Second People's Hospital, Affiliated Hospital of Nanjing Medical University, Changzhou 213001, China 1627879372@qq.com 
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Abstract::
      Objective To investigate the risk factors for acute radiation esophagitis andpneumonitis after radiation therapy in esophageal cancer (EC) patients with diabetes or hypertension.Methods A total of 373 EC patients receiving three dimensional conformal radiation therapy (3D-CRT) or intensity modulated radiation therapy (IMRT) were included in this study. Among these patients, 42 showed concurrent with diabetes and 99 with hypertension. Radiation esophagitis or pneumonitis in patients with or without diabetes, and with or without hypertension were monitored in the 1-year follow up, respectively.Results The prevalence of grade 1, 2, 3 and 4 radiation esophagitis in diabetes and non-diabetes patients was 40.5%, 38.1%, 14.3%, 4.8% and 66.2%, 27.8%, 2.7%, 1.8%, respectively, while that of the grade 1, 2 and 3 radiation pneumonitis in diabetes and non-diabetes patients was 31.0%, 16.7%, 9.5% and 30.8%, 15.7%,1.2%, respectively. The prevalence of grade 3 or above radiation esophagitis and pneumonitis in patients with diabetes and was significantly higher than those with non-diabetes (χ2=13.573, 12.279, P<0.05). The prevalence of grade 1, 2, 3 and 4 radiation esophagitis in hypertension and non-hypertension patients was 49.5%, 38.4%, 8.1%, 3.0% and 68.2%, 25.5%, 2.6%, 1.8%, respectively, while that of the grade 1, 2 and 3 radiation pneumonitis in hypertension and non-hypertension patients were 30.3%, 18.2%, 5.1% and 31.0%, 15.0%, 1.1%, respectively. The prevalence of grade 3 or above radiation esophagitis and pneumonitis in patients with hypertension was significantly higher than those with non-hypertension (χ2=5.695、5.422, P<0.05). Diabetes is an independent risk factor for grade 3 or above acute radiation esophagitis and pneumonitis.Conclusions Diabetes or hypertension might be risk factors for severe radiation esophagitis and pneumonitis in EC patients receiving radiation therapy.
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