Association between systemic chemotherapy before chemoradiation and increased risk of treatment-related pneumonitis in esophageal cancer patients treated with definitive chemoradiotherapy

Shulian Wang, Zhongxing Liao, Xiong Wei, H. Helen Liu, Susan L. Tucker, Chaosu Hu, Jaffer A. Ajani, Alexandria Phan, Stephen G. Swisher, Radhe Mohan, James D. Cox, Ritsuko Komaki

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)277-282
Number of pages6
JournalJournal of Thoracic Oncology
Volume3
Issue number3
DOIs
StatePublished - Mar 2008

Keywords

  • Concurrent chemotherapy
  • Esophageal cancer
  • Radiotherapy
  • Systemic chemotherapy
  • Treatment-related pneumonitis

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

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