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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.

thoracic cancer

Predictive factors for acute radiation pneumonitis in postoperative intensity modulated radiation therapy and volumetric modulated arc therapy of esophageal cancer