title: Prognostic parameters for acute esophagus toxicity in intensity modulated radiotherapy and concurrent chemotherapy for locally advanced non-small cell lung cancer.
abstract: OBJECTIVE
  The aim of this study was to correlate clinical and dosimetric variables with acute esophageal toxicity (AET) following Intensity Modulated Radiotherapy (IMRT) with concurrent chemotherapy for locally advanced non-small cell lung cancer (NSCLC). In addition, timeline of AET was reported.
  
  
  METHODS
  153 patients with locally advanced NSCLC treated with 66 Gy/2.75 Gy/24 fractions of radiotherapy and concurrent daily low dose cisplatin were selected. Medical records and treatments of these patients were retrospectively reviewed. Maximum AET grade ≥2 and maximum grade 3 were the endpoints of this study. Dates for onset, maximum and recovery (to baseline) of AET were reported. Univariate and multivariate analysis were applied to correlate clinical, tumor, dosimetric and chemotherapy dose variables to AET grade ≥2 and grade 3.
  
  
  RESULTS
  AET grade 2 occurred in 37% and grade 3 in 20% of the patients. The median onset of AET was around day 15 for all grades. The median onset of the maximum grade was day 30 for both grades 2 and 3. The median duration was 43 days for grade 1, 50 days for grade 2 and >80 days for grade 3. Of the grade 3 AET patients, 48% recovered within 3 months. Esophagus V50, ethnic background, and the number of cisplatin administrations were significantly correlated with grade 3 AET.
  
  
  CONCLUSIONS
  For NSCLC patients treated with concurrent chemotherapy and IMRT A higher number of cisplatin administrations, non-Caucasian background and higher V50oes were associated with grade 3 AET. The median onset of AET grade 3 is 15 days after the start of treatment, maximized at day 30, with a median duration of >80 days.
authors: Department of Thoracic Oncology, NKI-AVL, Amsterdam, The Netherlands. w.uyterlinde@nki.nl
authors: Wilma
authors: W
authors: Uyterlinde
authors: Chun
authors: C
authors: Chen
authors: Margriet
authors: M
authors: Kwint
authors: Josien
authors: J
authors: de Bois
authors: Andrew
authors: A
authors: Vincent
authors: Jan-Jakob
authors: JJ
authors: Sonke
authors: Jose
authors: J
authors: Belderbos
authors: Michel
authors: M
authors: van den Heuvel
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000532:radiotherapy*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D004947:Esophagus / Q000528:radiation effects*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D012189:Retrospective Studies
keywords: Concurrent chemoradiation; Esophagus toxicity; IMRT; Locally advanced non-small cell lung cancer