Dosimetric predictors of esophageal toxicity after stereotactic body radiotherapy for central lung tumors Journal Article


Authors: Wu, A. J.; Williams, E.; Modh, A.; Foster, A.; Yorke, E.; Rimner, A.; Jackson, A.
Article Title: Dosimetric predictors of esophageal toxicity after stereotactic body radiotherapy for central lung tumors
Abstract: 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 2 years, the probability of complication with BED10 D5cc > 14.4 Gy was 24%, compared to 1.6% if ≤14.4 Gy. 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 19.0 Gy for 3, 4, and 5 fractions, respectively, to keep the acute toxicity rate <20%. 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 = 10 Gy (BED10), dose-volume histogram variables for the esophagus (Dv and Vd) were assessed for correlation with grade ≥2 acute toxicity.
Keywords: esophagitis; lung; esophagus; sbrt; hypofractionated; central
Journal Title: Radiotherapy and Oncology
Volume: 112
Issue: 2
ISSN: 0167-8140
Publisher: Elsevier Inc.  
Date Published: 2014-08-01
Start Page: 267
End Page: 271
Language: English
DOI: 10.1016/j.radonc.2014.07.001
PROVIDER: scopus
PUBMED: 25064471
PMCID: PMC4254177
DOI/URL:
Notes: Export Date: 1 December 2014 -- Source: Scopus
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MSK Authors
  1. Andreas Rimner
    524 Rimner
  2. Abraham Jing-Ching Wu
    400 Wu
  3. Andrew Jackson
    253 Jackson
  4. Ellen D Yorke
    450 Yorke
  5. Amanda Foster
    64 Foster
  6. Ankit   Modh
    4 Modh