Review Article
Focus on treatment complications and optimal management: radiation oncology
Abstract
Background: Esophagitis and pneumonitis are the most important treatment complications and doselimiting toxicities in non-small cell lung cancer (NSCLC) patients treated with radiotherapy (RT) alone or combined modality therapy.
Methods: A literature research was performed to identify published articles relating clinical and dosimetric parameters associated with significant radiation pneumonitis (RP) and esophagitis in NSCLC patients treated with three-dimensional conformal RT.
Results: Possible clinical parameters associated with acute and or late esophagitis are concurrent chemoradiation, hyperfractionated and accelerated radiation regimens, dysphagia and neutropenia during treatment. Mean dose <34 Gy is currently used as standard dosimetric recommendation. Addition of chemotherapy and hyperfractionation are also associated with the risk of pneumonitis. Both the V20 and the mean lung dose are used as dosimetric parameter to correlate with the risk of high-grade radiation pneumonitis.
Conclusions: A variety of clinical and dosimetric parameters have been associated with acute and late toxicity. Treatment consist mainly in symptomatic relieve. Further research is necessary, as many studies led to different and sometimes even contradictory results.
Methods: A literature research was performed to identify published articles relating clinical and dosimetric parameters associated with significant radiation pneumonitis (RP) and esophagitis in NSCLC patients treated with three-dimensional conformal RT.
Results: Possible clinical parameters associated with acute and or late esophagitis are concurrent chemoradiation, hyperfractionated and accelerated radiation regimens, dysphagia and neutropenia during treatment. Mean dose <34 Gy is currently used as standard dosimetric recommendation. Addition of chemotherapy and hyperfractionation are also associated with the risk of pneumonitis. Both the V20 and the mean lung dose are used as dosimetric parameter to correlate with the risk of high-grade radiation pneumonitis.
Conclusions: A variety of clinical and dosimetric parameters have been associated with acute and late toxicity. Treatment consist mainly in symptomatic relieve. Further research is necessary, as many studies led to different and sometimes even contradictory results.
