Esophagus toxicity after stereotactic and hypofractionated radiotherapy for central lung tumors: Normal tissue complication probability modeling

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
M DuijmJoost Jan Nuyttens

Abstract

To correlate esophagus toxicity and dose-volume histogram (DVH) parameters in order to assess risks, and derive a Normal Tissue Complication Probability (NTCP) model. Patients with a central lung tumor from 2 centers, who underwent stereotactic or hypofractionated radiotherapy (≤12 fractions), were analyzed. Doses were recalculated to an equivalent dose of 2 Gy with an α/β ratio of 10 (EQD210). The esophagus was manually delineated and DVH-parameters (Dmax,EQD2, D1cc,EQD2, D2cc,EQD2, D5cc,EQD2) were analyzed and used for NTCP modeling based on logistic regression analysis. Two-hundred-and-thirty-one patients with 252 tumors were eligible. No acute or late grade 3-5 esophageal toxicity was reported. Acute grade 1-2 esophagus toxicity was recorded in 38 patients (17%). All DVH-parameters were significantly higher in patients with toxicity. NTCP models showed a 50% probability of acute grade 1-2 toxicity at a Dmax of 67 Gy EQD210 and D1cc of 42 Gy EQD210. No difference in overall survival was observed between patients with and without toxicity (p = 0.428). As no grade 3-5 esophageal toxicity was observed in our cohort, a Dmax of 56 Gy EQD210 and a D5cc of 35.5 Gy EQD210 could be delivered without high risks of severe toxicity. The...Continue Reading

Citations

Sep 25, 2020·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Mauro LoiMarta Scorsetti
Nov 30, 2018·International Journal of Radiation Oncology, Biology, Physics·Feng-Ming Spring KongEllen Yorke
Jun 27, 2021·Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists·Hatim FakirJoanna Laba

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