Open AccessPredictive factors for acute radiation pneumonitis in postoperative intensity modulated radiation therapy and volumetric modulated arc therapy of esophageal cancer
Author(s) -
Zhao Yaqin,
Chen Lu,
Zhang Shu,
Wu Qiang,
Jiang Xiaoqin,
Zhu Hong,
Wang Jin,
Li Zhiping,
Xu Yong,
Zhang Ying Jie,
Bai Sen,
Xu Feng
Publication year - 2015
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.12142
Subject(s) - medicine , radiation therapy , esophageal cancer , univariate analysis , pneumonitis , lung cancer , nuclear medicine , radiology , logistic regression , radiation treatment planning , lung , multivariate analysis , cancer
Background Radiation pneumonitis ( RP ) is a common side reaction in radiotherapy for esophageal cancer. There are few reports about RP in esophageal cancer patients receiving postoperative intensity modulated radiation therapy ( IMRT ) and volumetric modulated arc therapy ( VMAT ). This study aims to analyze clinical or dosimetric factors associated with RP , and provides data for radiotherapy planning. Methods We reviewed 68 postoperative esophageal cancer patients who were treated with radiotherapy at the West C hina H ospital from O ctober 2010 to N ovember 2012 to identify any correlation between the clinical or dosimetric parameters and acute radiation pneumonitis ( ARP ) or severe acute radiation pneumonitis ( SARP ) by t‐test, chi‐square test, and logistic regression analysis. Results Of the 68 patients, 33 patients (48.5%) developed ARP , 13 of which (19.1%) developed SARP . Of these 33 patients, 8 (11.8%), 12 (17.6%), 11 (16.2%), and 2 (2.9%) patients were grade 1, 2, 3, and 4 ARP , respectively. Univariate analysis showed that lung infection during radiotherapy, use of VMAT , mean lung dose ( MLD ), and dosimetric parameters (e.g. V20 , V30 ) are significantly correlated with RP . Multivariate analysis found that lung infection during radiotherapy, MLD ≥ 12 Gy, and V30 ≥ 13% are significantly correlated with an increased risk of RP . Conclusion Lung infection during radiotherapy and low radiation dose volume distribution were predictive factors associated with RP and should be accounted for during radiation planning.