Shandong Cancer Hospital and Institute Jinan, Shandong
L. Li1, J. Zhong1, X. Song Jr1, S. Shi1, and S. Yuan1,2; 1Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China, 2Department of Radiation Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China, Hefei, China
Purpose/Objective(s): Radiotherapy could inevitably damage normal tissue toxicity while killing tumor cells, such as the radiation-induced thoracic injury (RITT). However, the relationships between RITT and prognostic in locally advanced esophagus squamous cell cancer (ESCC) patients treated with definitive chemoradiotherapy (dCRT) remains undefined. Materials/
Methods: Totally 190 patients with locally advanced ESCC who underwent dCRT were enrolled in this analysis. Clinical features, radiation-induced lung injury (RILI) and radiation-induced esophagitis (RIE) were collected and graded by CTCAE. The prognostic values were assessed by univariate and multivariate Cox analyses and compared using the log-rank test. Results: In this study, 65 patients (34.21%) developed = grade 2 RIE, and 36 patients (18.95%) developed = grade 2 RILI. According to the univariate and multivariate analysis, RILI (HR (95% CI), 1.78 (1.16-2.73), p=0.008), RIE (HR (95% CI), 1.43 (0.99-2.08), p=0.05), clinical stage (HR (95%CI), 1.79 (1.11-2.88), p=0.016) and tumor location (HR (95% CI), 1.34 (1.07~1.69), p=0.011) were independently prognostic factors for PFS. The increased RITI grade was independently correlated with decreased PFS (log-rank, all p < 0.01). In the subgroup analysis, patients with RIE or RILI = grade 2 showed a significantly poorer PFS than patients with grade 0 and 1 RIE and RILI (log-rank, p=0.019 and p=0.002). Conclusion: The severity of RITI is an independent predictor of PFS, suggesting that avoiding radiation toxicity is essential to improve the prognosis in locally advanced ESCC patients.
