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Medline ® Abstract for Reference 50

of 'Taxane-induced pulmonary toxicity'

50
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Association between systemic chemotherapy before chemoradiation and increased risk of treatment-related pneumonitis in esophageal cancer patients treated with definitive chemoradiotherapy.
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Wang S, Liao Z, Wei X, Liu HH, Tucker SL, Hu C, Ajani JA, Phan A, Swisher SG, Mohan R, Cox JD, Komaki R
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J Thorac Oncol. 2008;3(3):277.
 
BACKGROUND: There is limited information on risk factors for treatment-related pneumonitis in esophageal cancer patients.
AIM OF THE STUDY: To determine factors associated with treatment-related pneumonitis in esophageal cancer patients treated with definitive chemoradiotherapy.
MATERIALS AND METHODS: We retrospectively reviewed clinical data from esophageal cancer patients treated with definitive chemoradiotherapy from 2000 to 2003. Demographic, clinical, and treatment-related data were collected for all patients. The time to occurrence of grade>or =2 pneumonitis was calculated from the end of radiotherapy. Univariate analyses were performed to determine the existence of any association between patient demographic, clinical, or treatment characteristics and pneumonitis.
RESULTS: In total, 96 patients were included in the study with a median follow-up of 8 months (range,<1-48 months). Among them, 23 patients also received an average of two cycles of systemic chemotherapy before the initiation of concurrent chemoradiation. The incidence of grade>or =2 pneumonitis was 22% at 1 year. Systemic chemotherapy before concurrent chemoradiation was significantly associated with an increased risk of grade>or =2 pneumonitis (p = 0.003), with the 1-year incidence of grade>or =2 pneumonitis for patients with and without systemic chemotherapy being 49 and 14%, respectively. No other clinical or dosimetric factors investigated were associated with the risk of grade>or =2 pneumonitis.
CONCLUSIONS: Systemic chemotherapy before concurrent chemoradiation was significantly associated with an increased risk of grade>or =2 pneumonitis, suggesting that induction chemotherapy may have sensitized the lung tissue to radiation damage in esophageal cancer patients.
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Department of Radiation Oncology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
PMID