title: Risk Analysis of Pneumonitis in Taxane Therapy After Chemoradiotherapy for Patients With Metastatic or Recurrent Esophageal Cancer.
abstract: OBJECTIVE
  Taxane chemotherapy for esophageal cancer causes pneumonitis, not only by itself but also by radiation recall. This study aimed to clarify the risk of pneumonitis in patients with esophageal cancer who receive taxane therapy after chemoradiotherapy.
  
  
  METHODS
  The data of 129 patients with metastatic or recurrent esophageal cancer who initiated taxane therapy between September 2002 and June 2013 were retrospectively analyzed. Patient selection criteria were as follows: performance status ≤2, preserved organ functions, previous chemoradiotherapy with a radiation dose of ≥50 Gy, grade 0 or 1 pneumonitis at taxane initiation, and no concomitant malignancy. Logistic regression analysis was performed to identify risk factors for pneumonitis.
  
  
  RESULTS
  Patient characteristics were as follows: males/females, 116/13; median age, 63 years (range, 44 to 80 y); performance status of 0/1/2, 61/60/8; smoking history, 112 (88%); location of the primary tumor Ce/Ut/Mt/Lt/Ae 12/30/66/20/1; median radiation dose, 60 Gy; history of radiation pneumonitis, 39 (30%); history of other pulmonary disease, 4 (3%); and median duration between the last radiation therapy (RT) exposure and taxane initiation, 6.1 months (range, 1.0 to 71 mo). During the median observation period of 7.8 months from taxane initiation, the incidence of grade 2 and 3 pneumonitis was observed in 7 (5.4%) and 3 (2.3%) patients, respectively. No patient died of pneumonitis. The only independent risk factor for pneumonitis was a ≤4-month period between the last RT exposure and taxane initiation (P=0.03).
  
  
  CONCLUSIONS
  A short period between the last RT exposure and taxane initiation is an independent risk factor for pneumonitis development.
authors.affiliation: Divisions of Gastrointestinal Oncology.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kishida
authors.affiliation: Divisions of Gastrointestinal Oncology.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsushima
authors.affiliation: Diagnostic Radiology.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Endo
authors.affiliation: Divisions of Gastrointestinal Oncology.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hamauchi
authors.affiliation: Divisions of Gastrointestinal Oncology.
authors.forename: Akiko
authors.initials: A
authors.lastname: Todaka
authors.affiliation: Divisions of Gastrointestinal Oncology.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Yokota
authors.affiliation: Divisions of Gastrointestinal Oncology.
authors.forename: Nozomu
authors.initials: N
authors.lastname: Machida
authors.affiliation: Divisions of Gastrointestinal Oncology.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamazaki
authors.affiliation: Divisions of Gastrointestinal Oncology.
authors.forename: Akira
authors.initials: A
authors.lastname: Fukutomi
authors.affiliation: Medical Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Onozawa
authors.affiliation: Divisions of Gastrointestinal Oncology.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yasui
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001952:Bridged-Ring Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D061214:Patient Safety; D011014:Pneumonia / Q000139:chemically induced* / Q000453:epidemiology* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane