UICC World Cancer Congress 2006

Objective:To analyze whether patient-specific factors (age, gender, smoking history) and dosimetric metrics predict acute esophagitis induced by neoadjuvant chemotherapy and radiotherapy

Methods:Sixty-one histology-proved lung cancer patients treated consecutively in our institution from December 2004 to May 2005 were studied. There were 12 females and 49 males with a median age of 58 years (ranged 23-76 years). All patients received conventional fractionated thoracic irradiation and neoadjuvant chemotherapy. Chemo-regimen consisted of NP and EP. Radiation dose ranged from 50 - 70 Gy. Dosimetric metrics as (Dmax), mean dose (Dmean), V10, V20, V30, V40 and V50 of the esophagus were generated. In univariate analysis, various dosimetric and patient-specific (age, gender, smoking history) parameters were studied. Logistic step-wise regression analysis was used to determine significant predictors to CTCAE 3.0 Grade 問 2 acute esophagitis.

Results:Forty-one Of 61 (67%) patients developed CTCAE 3.0 Grade 問 2 acute esophagitis. The most statistically significant single parameter for predicting acute esophagitis was mean dose of the esophagus (p = 0.008). Maximum dose of the esophagus and V40 had marginal significance correlating with acute esophagitis, p = 0.052 and 0.069, respectively. Age, gender, smoking history (ever vs. none) and other metrics had no statistically significant influence on the incidence of acute esophagitis (p = 0.08 每 0.81). On logistic regression analysis, only mean dose remained significantly correlated with Grade 問 2 acute esophagitis, p = 0.0345. Conclusions: The single best predictor for CTCAE 3.0 Grade 問 2 acute esophagitis was mean dose of the esophagus in this group of patients.