Acute Esophageal Damage in Patients with Inoperable Non-small Cell Lung Cancer Treated with Concurrent and Sequential Chemoradiotherapy

Abstract

Abstract BACKGROUND: Acute esophageal damage may be a dose-limited factor for application the full planning radiotherapy (RT) dose in patients with inoperable non-small cell lung cancer (NSCLC). A combination of chemotherapy and RT may increase esophageal toxicity, but three-dimensional (3D) conformal RT offers better sparing of the organs at risk.

AIM: The purpose of this study was to show the incidence and degree of acute esophageal damage in lung cancer patients treated with sequential and concurrent chemoradiotherapy.

MATERIALS AND METHODS: The total number was 73 patients, of whom 26 (34.7%) had previously received sequential chemotherapy with a four-cycle followed by RT. In the second concurrent group, 47 (65.3%) patients were received concomitant chemotherapy and RT.

RESULTS: Of the 73 patients included in the study, 43 (57.3%) did not present any grade of esophagitis during the treatment. In the sequential group, 73.1% presented no esophagitis and in the concurrent group, 49%, respectively. Although there were differences between the two groups, none were statistically significant.

CONCLUSIONS: The reason for the good tolerability of the combination of chemotherapy and RT for inoperable NSCLC patients was using 3D conformal RT. Further improvements may be obtained with more sophisticated RT or radioprotective drugs.