Dosimetric predictors of radiation esophagitis in patients treated for non-small-cell lung cancer with carboplatin/paclitaxel/radiotherapy

Purpose: To establish dosimetric predictors of radiation esophagitis (RE) in patients treated with a combination of carboplatin, paclitaxel, and radiotherapy. Methods and Materials: Three-dimensional radiotherapy plans of 26 patients with non-small-cell lung cancer who received 50-60 Gy of radiotherapy concurrently with weekly administration of carboplatin (AUC 2) and paclitaxel (40-45 mg/m(2)) were reviewed in conjunction with RE. The factors analyzed included the following: percentages of organ volumes receiving > 40 Gy (V40), > 45 Gy (V45), > 50 Gy (V50), and > 55 Gy (V55); the length of esophagus (total circumference) treated with > 40 Gy (LETT40), > 45 Gy (LETT45), >50 Gy (LETT50), and > 55 Gy (LETT55); the maximum dose in the esophagus (Dmax); and the mean dose in the esophagus (Dmean). Data were obtained on the basis of superposition algorithm. Results: All factors except Dmax showed statistical correlation with RE. Good correlations were shown between RE and LETT45 (p = 0.714) and V45 (p = 0.686). Conclusions: LETT45 and V45 appear to be useful dosimetric predictors of RE. It is also suggested that Dmax does not predict RE. (C) 2001 Elsevier Science Inc.