title: Dose-volumetric parameters and prediction of severe acute esophagitis in patients with locally-advanced non small-cell lung cancer treated with neoadjuvant concurrent hyperfractionated-accelerated chemoradiotherapy.
abstract: BACKGROUND
  To identify dose-volume parameters predictive for severity of acute esophagitis (CTC > grade 2) in locally-advanced non small-cell lung cancer (LA-NSCLC) patients treated with neoadjuvant concurrent hyperfractionated-accelerated chemoradiotherapy (HA-CRT) a retrospective analysis was performed. 88 patients were treated with HA-CRT followed by radical surgery. Predictive power of absolute oesophageal length, absolute and relative oesophageal volume included in the 95%-isodose, patient- and tumor-related factors for severity of acute esophagitis was assessed.
  
  
  RESULTS
  A total of 82 patients (93%) developed radiation-induced acute esophagitis. Grade 1 was documented in 1 (1%), grade 2 in 55 (67%), grade 3 in 23 (28%) and grade 4 in 3 (4%) patients, respectively. Absolute oesophageal volume included in the 95%-isodose (42.8 Gy) achieved 13.5 cm3 (range: 3 - 29 cm3). Of the tested variables in univariate analysis, absolute oesophageal volume included in the 95%-Isodose was found to be the only significant variable (p = 0.03) predicting severe acute esophagitis (CTC > grade 2). For this volume a gradation scale of the likelihood of severity was built.
  
  
  CONCLUSIONS
  Increase of absolute oesophageal volume included in the 95%-isodose correlates with severity of acute esophagitis in LA-NSCLC patients treated with neo-adjuvant concurrent HA-CRT.
authors.forename: Farkhad
authors.initials: F
authors.lastname: Manapov
authors.forename: Susanna
authors.initials: S
authors.lastname: Sepe
authors.forename: Maximilian
authors.initials: M
authors.lastname: Niyazi
authors.forename: Claus
authors.initials: C
authors.lastname: Belka
authors.forename: Godehard
authors.initials: G
authors.lastname: Friedel
authors.forename: Wilfried
authors.initials: W
authors.lastname: Budach
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D017322:Clinical Trials, Phase II as Topic; D019583:Dose Fractionation, Radiation; D004941:Esophagitis / Q000209:etiology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011832:Radiation Injuries / Q000209:etiology*; D012189:Retrospective Studies