Esophageal cancer radiotherapyAnalysis of dose–volume histogram parameters for radiation pneumonitis after definitive concurrent chemoradiotherapy for esophageal cancer
Section snippets
Patients and methods
The medical and radiation records of all esophageal cancer patients treated with concurrent chemoradiotherapy at Shizuoka Cancer Center Hospital between September 2002 and December 2004 were retrospectively reviewed. Of 129 patients with squamous cell carcinoma, we identified a total of 37 patients who met the following inclusion criteria: (1) carcinoma of thoracic esophagus; (2) concomitant chemotherapy consisting of 5-fluorouracil and cisplatin; (3) follow-up time >1 year from start of
Results
The patients’ characteristics are shown in Table 1. There were 36 men and 1 woman with a median age of 64 years (range, 47–75 years). The median follow-up period from the start of radiotherapy was 32.2 months (range, 12.6–47.5 months). The median follow-up for the 24 surviving patients was 33.7 months (range, 19.8–47.5 months). All stage IVB patients in this study were categorized as stage IVB due to the existence of non-regional lymph node metastasis such as supraclavicular lymph node. No patient
Discussion
The present study showed the relationship between DVH parameters and the occurrence of symptomatic RP in esophageal cancer patients treated with definitive chemoradiotherapy. The incidence of grade 2 or higher RP in patients with a V20 of ⩾37% was high (78%) in the present study. In studies investigating the relationship between the incidence of RP and DVH parameters in lung cancer patients, many authors [2], [4], [9], [12], [13] have graded RP according to the National Cancer Institute-Common
Conclusion
Our findings suggest that DVH parameters are predictors of symptomatic RP after definitive concurrent chemoradiotherapy for esophageal cancer and should be considered in the evaluation of treatment planning.
Conflict of interest statement
The authors have no conflict of interest in connection with the paper.
Acknowledgments
The authors thank Haruo Yamashita (medical physicist, Division of Proton Therapy, Shizuoka Cancer Center) and Atsushi Kawaguchi (biostatistician, Biostatistics Center, Kurume University) for their support in this analysis.
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