The Research On Hyperfractionated Accelerated Radiotherapy Acute Radiation-Induced Esophagitis For Lung Cancer

Objective: To observed the incidence of acute radiation esophagitis and analyze the factors as predictors of acute radiotherapy acuteradiation-induced esophagitis for Locally advanced non-small cell lung cancer(LA-NSCLC) patients treated with 3DCRT were reviewe concurrent chemotherapy.The clinical and dosimetric factors associated with radiation-induced esophagitis were analyzed by using univariate analysis.To analyze the efficacy and safety of hyperfractionated accelerated radiotherapy for the treatment of lung cancer and to provide the reference standard for the clinical best treatment plan.To assess the predictive ability of dosimetric paramters in those patient.Method: Form January 2008 to January 2011, 48 patients with LA-NSCLC were registered. The patients were allocated to treatment group (24 cases), treated with hyperfractionated accelerated radiotherapy.Radiotherapy was delivered at 1.4 Gy fraction b.i.d 56-64.4 Gy/ 40-45 fix.The control group (24 cases) throated with conventional fractionation, with delivered at 2 Gy fraction q.d 60-66 Gy/30-33 fx.All patients received concurrent chemotherapy with etoposide combined with cisplatin.Esophageal toxicity was graded according to the RTOG criteria.The factors were analyzed with respect to their association with≥2 Grade esophagitis by univariate and multivariate analyses.Results: All patients completed the therapy plan.The Hyperfractionated group were significantly associated with acute grade 2 or worse radiation esophagitls than the Conventional group (50.00 % vs 20.83 %, P=0.037).The 3 or worse radiation esophagitls were 25.00 % vs 4.16 % (P=0.043).The Hyperfractionated group incidence of acute radiation esophagitis appear at 10 day( total cumulative tumor dose of 22.4 Gy), reached a plateau after 17 day and did not further increase there after 4 weeks.The Conventional group incidence of acute radiation esophagitis appear at 16 day ( total cumulative tumor dose of 24 Gy), reached a plateau after 19 day.The LETT30,LETT35 and V35 of esophagus were strong predictors of grade 2 or worse AE(P<0.01) and LETT45,V50 were strong predictors of grade 3 or worse AE(P<0.01)in lung cancer treated with hyperfractionated accelerated radiotherapy.Conelusion: The Hyperfractionated accelerated radiotherapy combine concurrent chemotherapy were significantly associated with acute grade 2 or worse radiation esophagitls than the Conventional fractionation.The dosimetry Indicator Contain LETT35,LETT45,V30,V50 and total weeks cumulative tumor dose of esophagus were significantly associated with acute radiation esophagitls in lung cancer treated with Hyperfractionated accelerated radiotherapy(P<0.01).