Dosimetric and clinical predictors for radiation-induced esophageal injury

Sung Ja Ahn, Daniel Kahn, Sumin Zhou, Xiaoli Yu, Donna Hollis, Timothy D. Shafman, Lawrence B. Marks

Research output: Contribution to journalArticle

108 Citations (Scopus)

Abstract

To evaluate the clinical and three-dimensional dosimetric parameters associated with esophageal injury after radiotherapy (RT) for non-small-cell lung cancer. The records of 254 patients treated for non-small-cell lung cancer between 1992 and 2001 were reviewed. A variety of metrics describing the esophageal dose were extracted. The Radiation Therapy Oncology Group toxicity criteria for grading of esophageal injury were used. The median follow-up time for all patients was 43 months (range, 0.5-120 months). Logistic regression analysis, contingency table analyses, and Fisher's exact tests were used for statistical analysis. Acute toxicity occurred in 199 (78%) of 254 patients. For acute toxicity of Grade 2 or worse, twice-daily RT, age, nodal stage of N2 or worse, and most dosimetric parameters were predictive. Late toxicity occurred in 17 (7%) of 238 patients. The median and maximal time to the onset of late toxicity was 5 and 40 months after RT, respectively. Late toxicity occurred in 2%, 3%, 17%, 26%, and 100% of patients with acute Grade 0, 1, 2, 3, and 4 toxicity, respectively. For late toxicity, the severity of acute toxicity was most predictive. A variety of dosimetric parameters are predictive of acute and late esophageal injury. A strong correlation between the dosimetric parameters prevented a comparison between the predictive abilities of these metrics. The presence of acute injury was the most predictive factor for the development of late injury. Additional studies to define better the predictors of RT-induced esophageal injury are needed.

Original languageEnglish (US)
Pages (from-to)335-347
Number of pages13
JournalInternational Journal of Radiation Oncology Biology Physics
Volume61
Issue number2
DOIs
StatePublished - Feb 1 2005

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toxicity
Radiation
Radiotherapy
Wounds and Injuries
radiation
predictions
radiation therapy
Non-Small Cell Lung Carcinoma
lungs
Radiation Oncology
grade
cancer
contingency
Logistic Models
Regression Analysis
logistics
statistical analysis
regression analysis
dosage

Keywords

  • Esophageal toxicity
  • Non-small-cell lung cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Dosimetric and clinical predictors for radiation-induced esophageal injury. / Ahn, Sung Ja; Kahn, Daniel; Zhou, Sumin; Yu, Xiaoli; Hollis, Donna; Shafman, Timothy D.; Marks, Lawrence B.

In: International Journal of Radiation Oncology Biology Physics, Vol. 61, No. 2, 01.02.2005, p. 335-347.

Research output: Contribution to journalArticle

Ahn, Sung Ja ; Kahn, Daniel ; Zhou, Sumin ; Yu, Xiaoli ; Hollis, Donna ; Shafman, Timothy D. ; Marks, Lawrence B. / Dosimetric and clinical predictors for radiation-induced esophageal injury. In: International Journal of Radiation Oncology Biology Physics. 2005 ; Vol. 61, No. 2. pp. 335-347.
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