TY - JOUR
T1 - Association between systemic chemotherapy before chemoradiation and increased risk of treatment-related pneumonitis in esophageal cancer patients treated with definitive chemoradiotherapy
AU - Wang, Shulian
AU - Liao, Zhongxing
AU - Wei, Xiong
AU - Liu, H. Helen
AU - Tucker, Susan L.
AU - Hu, Chaosu
AU - Ajani, Jaffer A.
AU - Phan, Alexandria
AU - Swisher, Stephen G.
AU - Mohan, Radhe
AU - Cox, James D.
AU - Komaki, Ritsuko
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2008/3
Y1 - 2008/3
N2 - BACKGROUND: There is limited information on risk factors for treatment-related pneumonitis in esophageal cancer patients. AIM OF THE STUDY: To determine factors associated with treatment-related pneumonitis in esophageal cancer patients treated with definitive chemoradiotherapy. MATERIALS AND METHODS: We retrospectively reviewed clinical data from esophageal cancer patients treated with definitive chemoradiotherapy from 2000 to 2003. Demographic, clinical, and treatment-related data were collected for all patients. The time to occurrence of grade ≥2 pneumonitis was calculated from the end of radiotherapy. Univariate analyses were performed to determine the existence of any association between patient demographic, clinical, or treatment characteristics and pneumonitis. RESULTS: In total, 96 patients were included in the study with a median follow-up of 8 months (range, <1-48 months). Among them, 23 patients also received an average of two cycles of systemic chemotherapy before the initiation of concurrent chemoradiation. The incidence of grade ≥2 pneumonitis was 22% at 1 year. Systemic chemotherapy before concurrent chemoradiation was significantly associated with an increased risk of grade ≥2 pneumonitis (p = 0.003), with the 1-year incidence of grade ≥2 pneumonitis for patients with and without systemic chemotherapy being 49 and 14%, respectively. No other clinical or dosimetric factors investigated were associated with the risk of grade ≥2 pneumonitis. CONCLUSIONS: Systemic chemotherapy before concurrent chemoradiation was significantly associated with an increased risk of grade ≥2 pneumonitis, suggesting that induction chemotherapy may have sensitized the lung tissue to radiation damage in esophageal cancer patients.
AB - BACKGROUND: There is limited information on risk factors for treatment-related pneumonitis in esophageal cancer patients. AIM OF THE STUDY: To determine factors associated with treatment-related pneumonitis in esophageal cancer patients treated with definitive chemoradiotherapy. MATERIALS AND METHODS: We retrospectively reviewed clinical data from esophageal cancer patients treated with definitive chemoradiotherapy from 2000 to 2003. Demographic, clinical, and treatment-related data were collected for all patients. The time to occurrence of grade ≥2 pneumonitis was calculated from the end of radiotherapy. Univariate analyses were performed to determine the existence of any association between patient demographic, clinical, or treatment characteristics and pneumonitis. RESULTS: In total, 96 patients were included in the study with a median follow-up of 8 months (range, <1-48 months). Among them, 23 patients also received an average of two cycles of systemic chemotherapy before the initiation of concurrent chemoradiation. The incidence of grade ≥2 pneumonitis was 22% at 1 year. Systemic chemotherapy before concurrent chemoradiation was significantly associated with an increased risk of grade ≥2 pneumonitis (p = 0.003), with the 1-year incidence of grade ≥2 pneumonitis for patients with and without systemic chemotherapy being 49 and 14%, respectively. No other clinical or dosimetric factors investigated were associated with the risk of grade ≥2 pneumonitis. CONCLUSIONS: Systemic chemotherapy before concurrent chemoradiation was significantly associated with an increased risk of grade ≥2 pneumonitis, suggesting that induction chemotherapy may have sensitized the lung tissue to radiation damage in esophageal cancer patients.
KW - Concurrent chemotherapy
KW - Esophageal cancer
KW - Radiotherapy
KW - Systemic chemotherapy
KW - Treatment-related pneumonitis
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U2 - 10.1097/JTO.0b013e3181653ca6
DO - 10.1097/JTO.0b013e3181653ca6
M3 - Article
C2 - 18317071
AN - SCOPUS:43249084440
SN - 1556-0864
VL - 3
SP - 277
EP - 282
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 3
ER -