Clinical and dosimetric factors of radiation-induced esophageal injury: Radiation-induced esophageal toxicity
Clinical and dosimetric factors of radiation-induced esophageal injury: Radiation-induced esophageal toxicity
复制标题
DOI：
10.3748/wjg.v11.i17.2626
复制
发表时间：
2005-05-07
影响因子：
4.3
通讯作者：
Wang, Rui-Zhi
中科院分区：
文献类型：
--
作者：
Qiao, Wen-Bo;Zhao, Yan-Hui;Wang, Rui-Zhi
目的：分析三维适形放射治疗(3D-CRT)中非小细胞肺癌(NSCLC)患者发生放射性食道损伤的临床和剂量学预测因素。方法：对连续208例非小细胞肺癌患者(男146例，女62例)行3D-CRT治疗。患者年龄中位数为(35~87岁)。临床和治疗参数包括性别、年龄、功能状态、序贯化疗、同步化疗、隆突或隆突下淋巴结的存在、治疗前体重减轻、全食道平均剂量、食道最大点剂量和接受~GT；55GY的食道体积百分比。结果：208例患者中有25例(12%)发生了急性或晚期3-5级食道损伤。其中9例合并急性和晚期3~5级食道损伤，2例死于晚期食道穿孔。同期化疗和食管点最大剂量60GY与3~5级食道损伤的风险显著相关。208名患者中有54名(26%)同时接受了化疗。其中25例(46%)发生3~5级食道损伤(P=0.0001
AIM: To analyze the clinical and dosimetric predictive factors for radiation-induced esophageal injury in patients with non-small-cell lung cancer (NSCLC) during three-dimensional conformal radiotherapy (3D-CRT).METHODS: We retrospectively analyzed 208 consecutive patients (146 men and 62 women) with NSCLC treated with 3D-CRT. The median age of the patients was 64 years (range 35-87 years). The clinical and treatment parameters including gender, age, performance status, sequential chemotherapy, concurrent chemotherapy, presence of carinal or subcarinal lymph nodes, pretreatment weight loss, mean dose to the entire esophagus, maximal point dose to the esophagus, and percentage of volume of esophagus receiving >55 Gy were studied. Clinical and dosimetric factors for radiation-induced acute and late grade 3-5 esophageal injury were analyzed according to Radiation Therapy Oncology Group (RTOG) criteria.RESULTS: Twenty-five (12%) of the two hundred and eight patients developed acute or late grade 3-5 esophageal injury. Among them, nine patients had both acute and late grade 3-5 esophageal injury, two died of late esophageal perforation. Concurrent chemotherapy and maximal point dose to the esophagus 60 Gy were significantly associated with the risk of grade 3-5 esophageal injury. Fifty-four (26%) of the two hundred and eight patients received concurrent chemotherapy. Among them, 25 (46%) developed grade 3-5 esophageal injury (P = 0.0001