Yazarlar : Wu A, Williams E, Modh A et al

Yayın : Radiother Oncol

Yayın Yılı : 2014

Pubmed Linki : http://www.docguide.com/dosimetric-predictors-esophageal-toxicity-after-stereotactic-body-radiotherapy-central-lung-tumors?tsid=5

Konu : Radyasyon Onkolojisi

Literatür İçeriği :  BACKGROUND AND PURPOSE Stereotactic body radiotherapy (SBRT) to central lung tumors can cause esophageal toxicity, but little is known about the incidence or risk factors. We reviewed central lung SBRT patients to identify dosimetric factors predictive of esophageal toxicity.

MATERIALS AND METHODS We assessed esophageal toxicity in 125 SBRT patients. Using biological equivalent doses with α/β=10Gy (BED10), dose-volume histogram variables for the esophagus (Dv and Vd) were assessed for correlation with grade ⩾2 acute toxicity.

RESULTS Incidence of grade ⩾2 acute toxicity was 12% (n=15). Highly significant logistic models were generated for D5cc and Dmax (p<0.001). To keep the complication rate<20%, the model requires that D5cc⩽26.3 BED10. At 2years, the probability of complication with BED10D5cc>14.4Gy was 24%, compared to 1.6% if ⩽14.4Gy.

CONCLUSIONS This novel analysis provides guidelines to predict acute esophageal toxicity in lung SBRT. Dose to the hottest 5cc and Dmax of the esophagus were the best predictors of toxicity. Converting the BED10 limits to physical doses, D5cc to the esophagus should be kept less than 16.8, 18.1 and 19.0Gy for 3, 4, and 5 fractions, respectively, to keep the acute toxicity rate<20%.

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