Back to Journals » OncoTargets and Therapy » Volume 11

Clinical, dosimetric, and position factors for radiation-induced acute esophagitis in intensity-modulated (chemo)radiotherapy for locally advanced non-small-cell lung cancer

Authors Huang J, He TY, Yang RH, Ji TL, Li G

Received 18 May 2018

Accepted for publication 14 August 2018

Published 21 September 2018 Volume 2018:11 Pages 6167—6175


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Cho

Jin Huang,1 Tianyu He,1 Ronghui Yang,2 Tianlong Ji,1 Guang Li1

1Department of Radiotherapy, The First Hospital of China Medical University, Shenyang 110001, China; 2Department of Hematology, Shengjing Hospital of China Medical University, Shenyang 110000, China

Purpose: The purpose of this study was to estimate the relation between acute esophagitis (AE) and clinical, dosimetric, and position factors in patients with locally advanced non-small-cell lung cancer (NSCLC) receiving intensity-modulated (chemo)radiotherapy.
Materials and methods: A retrospective cohort analysis was performed to identify factors associated with Common Toxicity Criteria for Adverse Events grade 2 or worse AE (AE2+). A multivariable model was established including patient- and treatment-related variables and esophageal dose–volume histogram parameters. The esophagus was divided according to physiological anatomy, and logistic regression was used to analyze the position parameter for its correlation with AE2+.
Results: The incidence of AE2+ was 27.5%. All models included gender, concurrent chemoradiotherapy (CCRT), position parameter, and one of the dosimetric variables. The model with mean dose showed the best goodness of fit. Gender (OR=2.47, P=0.014), CCRT (OR=3.67, P=0.015), mean dose (OR=1.33, P<0.001), and maximum radiation position (OR=1.65, P=0.016) were significantly related to AE2+.
Conclusion: Gender, concurrent chemotherapy, maximum radiation position, and mean dose were independent risk factors for AE2+. The upper part of the esophagus showed a higher sensitivity to radiation toxicity.

Keywords: acute esophagitis, non-small-cell lung cancer, intensity-modulated radiation therapy, position parameter

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]