Dosimetric and clinical predictors for radiation-induced esophageal injury

Ahn, Sung‐Ju; Kahn, Daniel; Zhou, Sumin; Yu, Xiaoli; Hollis, Donna; Shafman, Timothy D.; Marks, Lawrence B.

doi:10.1016/j.ijrobp.2004.06.014

Cited by 157 publications

(121 citation statements)

References 31 publications

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“…Clinical and dosimetric factors may be related to the incidence and severity of acute radiation esophagitis. These factors are: age (Ahn et al, 2005) tumor stage (Choy et al, 1998) , nodal stage (Belderbos et al, 2005), concurrent chemoirradiation (Choy et al, 1998), mean esophageal dose and maximal dose point (Etiz et al,…”

Section: Introductionmentioning

confidence: 99%

Oral Glutamine Supplementation Reduces Radiotherapy-induced Esophagitis in Lung Cancer Patients

Kanyılmaz¹,

Muge²,

A³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: The purpose of this study was to assess the the efficacy of oral glutamine (GLN) in prevention of acute radiation-induced esophagitis in patients with lung cancer and determine the predictive role of clinical and dosimetric parameters. Materials and Methods: Thirty-two patients diagnosed with lung cancer were studied prospectively. Sixteen patients (50%) received prophylactic powdered GLN orally in doses of 10g/8h. Patients were treated 2 Gy per fraction daily, 5 days a week. We evaluated the grading of esophagitis daily at the end of each fraction of each treatment day until a cumulative dose of 50 Gy was reached. The primary end point was radiation-induced esophagitis. Results: All patients tolerated GLN well. Toxicity grade, weight loss, serum cytokine levels and esophageal transit times exhibited statistically significant improvement in the GLN receiving group. GLN suppressed the inflammation related to the disease and treatment and reduced toxicity with statistical significance. Conclusions: This study suggests a benefical role of oral GLN use in prevention and/or delay of radiation-induced esophagitis, in terms of esophageal transit time and serum immunological parameters, as well as weight loss.

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Section: Introductionmentioning

confidence: 99%

Oral Glutamine Supplementation Reduces Radiotherapy-induced Esophagitis in Lung Cancer Patients

Kanyılmaz¹,

Muge²,

A³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…Nevertheless, there are studies reporting no effects of CRT on the development of AE. In a series of 254 cases by Ahn et al (2005) no differences were found in the rate of development of AE between the etoposide, gemcitabine, paclitaxel, carboplatin, and cisplatin-based CRT arm (32 cases) and no CRT arm (p=0.30). Takeda, confirmed the fact that CRT administration alone is not associated with the development of AE in his series of 35 cases (Takeda et al, 2005).…”

Section: Discussionmentioning

confidence: 91%

“…Various dosimetric and clinical factors have been reported to affect AE (Table 7) (Maguire et al, 1999;Werner Wasik et al, 2000;Singh et al, 2003;Bradley et al, 2004;Ahn et al, 2005;Court et al, 2012). Bradley et al (2004) administered cisplatin, etoposide, gemcitabine, paclitaxel, and carboplatin-based CRT in their study performed in 166 cases with stages I-III NSCLC (25% patients).…”

Section: Discussionmentioning

confidence: 99%

Dosimetric and Clinical Predictors of Acute Esophagitis in Lung Cancer Patients in Turkey Treated with Radiotherapy

Etiz

Bayman²,

Akçay³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…When it occurs, AE often peaks in the first few weeks of a course of radiation therapy. [1][2][3] Patient-related, tumor-related, and treatment-related risk factors [3][4][5][6][7][8] that have been reported to be statistically associated with the incidence or severity of AE include age, tumor nodal stage, concurrent chemotherapy, and body mass index. Two recent reviews 9,10 summarized the dosimetric predictors.…”

Section: Introductionmentioning

confidence: 99%

“…Rose et al 9 systematically reviewed 18 published studies of patients with nonesmall cell lung cancer who had radiation-induced esophagitis. [3][4][5][6][7][11][12][13][14][15][16][17][18][19][20][21][22][23] Eleven studies specifically assessed AE, and the other studies assessed acute and chronic radiation-induced esophagitis together. Five dosimetric parameters were identified as predictive of AE with or without chemotherapy: mean esophageal dose (MED), maximal esophageal dose, percentage of esophagus volume receiving !20 Gy (V20), V35, and V60.…”

Section: Introductionmentioning

confidence: 99%

Independent Test of a Model to Predict Severe Acute Esophagitis

Huang

Robinson

Molotievschi

et al. 2012

International Journal of Radiation Oncology*Biology*Physics

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Purpose: Treatment planning factors are known to affect the risk of severe acute esophagitis during thoracic radiation therapy. We tested a previously published model to predict the risk of severe acute esophagitis on an independent data set. Methods and materials:The data set consists of data from patients who had recoverable treatment plans and received definitive radiation therapy for nonesmall cell carcinoma of the lung at a single institution between November 2004 and January 2010. Complete esophagus dose-volume and available clinical information was extracted using our in-house software. The previously published model was a logistic function with a combination of mean esophageal dose and use of concurrent chemotherapy. In addition to testing the previous model, we used a novel, machine learning-based method to build a maximally predictive model. Results: Ninety-four patients (81.7%) developed Common Terminology Criteria for Adverse Events, Version 4, Grade 2 or more severe esophagitis (Grade 2: n Z 79 and Grade 3: n Z 15). Univariate analysis revealed that the most statistically significant dose-volume parameters included percentage of esophagus volume receiving !40 to 60 Gy, minimum dose to the highest 20% of esophagus volume (D20) to D35, and mean dose. Other significant predictors included concurrent chemotherapy and patient age. The previously published model predicted risk effectively with a Spearman's rank correlation coefficient (r s ) of 0.43 (P < .001) with good calibration (HosmerLemeshow goodness of fit: P Z .537). A new model that was built from the current data set found the same variables, yielding an r s of 0.43 (P < .001) with a logistic function of 0.0853 Â mean esophageal dose [Gy] Lemeshow P Z .659. A novel preconditioned least absolute shrinkage and selection operator method yielded an average r s of 0.38 on 100 bootstrapped data sets. Conclusions: The previously published model was validated on an independent data set and determined to be nearly as predictive as the best possible two-parameter logistic model even though it overpredicted risk systematically. A novel, machine learning-based model using a bootstrapping approach showed reasonable predictive power.

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Dosimetric and clinical predictors for radiation-induced esophageal injury

Cited by 157 publications

References 31 publications

Oral Glutamine Supplementation Reduces Radiotherapy-induced Esophagitis in Lung Cancer Patients

Oral Glutamine Supplementation Reduces Radiotherapy-induced Esophagitis in Lung Cancer Patients

Dosimetric and Clinical Predictors of Acute Esophagitis in Lung Cancer Patients in Turkey Treated with Radiotherapy

Independent Test of a Model to Predict Severe Acute Esophagitis

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