Clinical and dosimetric factors of radiation-induced esophageal injury: Radiation-induced esophageal toxicity

Table 1 Patient characteristics.

Age (yr)	Gender (%)	Performance (%)	Weight loss (%)	Histologic type status (%)
Range 35-87	Male (70)	KPS≥70 to 95	<575%	Squamous cell carcinoma (60)
Median 66	Female (30)	KPS<70 to 5	≥525%	Adenocarcinoma (14) Undifferentiated large cell (24) NSCLC, OT (2)

KPS, Karnofsky performance status; NSCLC, non-small-cell lung cancer; OT, otherwise type.

Table 2 Concurrent chemotherapy agents used.

Patients (n)	Concurrent chemotherapy
25	Cisplatin and etoposide
4	Cisplatin
2	Cisplatin, etoposide, and gemcitabine
6	Cisplatin and 5-fluorouracil
1	Cisplatin and Navelbine
5	Cisplatin, Navelbine and gemcitabine
5	Carboplatin and Taxol
3	Gemcitabine
3	Taxotere

Table 3 RTOG grading for acute esophageal injury.

Grade	Description
0	No change
1	Mild dysphagia or odynophagia, requiring topical anesthetic, non-narcotic agents, or soft diet
2	Moderate dysphagia or odynophagia, requiring narcotic agents or liquid diet
3	Severe dysphagia or odynophagia with dehydration or weight loss (>15% of pretreatment baseline), requiring nasogastric feeding
4	Complete stricture, ulceration, perforation or fistula
5	Death

RTOG, Radiation Therapy Oncology Group. During the follow-up period, chest X-ray examination was performed at intervals of 2-3 mo. CT scan of the chest was carried out every 2-3 mo after treatment, or earlier if clinically indicated.

Table 4 Distribution of acute and late esophageal injury.

Pt. no.	Late esophageal injury	Acute esophageal injury
1	3	3
2	1	3
3	3	3
4	3	3
5	1	3
6	2	4
7	3	3
8	3	1
9	3	5
10	3	1
11	2	3
12	3	3
13	3	3
14	4	5
15	0	3
16	3	3
Total	11	14

RTOC, Radiation Therapy Oncology Group; Pt. no., patient number.

Table 5 Analysis of factors predicting esophageal injury.

Variable	Univariate (P)	Multivariate (P)
Concurrent chemotherapy	0.0001	0.0090
Maximal dose point ≥60 Gy	0.0001	0.0010
Mean esophageal dose ≥40 Gy	0.0341	0.1023
Carinal or subcarinal nodes	0.0145	0.2136
Sequential chemotherapy	0.3680	0.1467
Volume >55 Gy	0.1699	0.1235
Age (yr)	0.3064	0.1354
Gender	0.4947	0.1213
Weight loss	0.3608	0.1302