Postoperative pulmonary complications after preoperative chemoradiation for esophageal carcinoma: correlation with pulmonary dose-volume histogram parameters.

摘要: Purpose To clarify the relationship between percentage of lung receiving low radiation doses with concurrent chemotherapy and occurrence postoperative pulmonary complications in treatment esophageal carcinoma. Methods From 117 patients who underwent preoperative chemoradiation for cancer at our institution 1998 2002, we selected 61 whom complete dose–volume histogram (DVH) data were available analyzed incidence pneumonia acute respiratory distress syndrome (ARDS) this group. All received therapy, 39 also induction before chemoradiation. The median age was 62 years, radiotherapy dose 45 Gy. volume least 10 Gy (V10), 15 (V15), 20 (V20) recorded from each DVH. Results Eleven (18%) had complications, 2 died after progression pneumonia. Pulmonary noted more often (35% vs. 8%, p = 0.014) when V10 ≥40% <40% V15 ≥30% < 30% (33% 10%, 0.036). An apparent increase complication rate V20 ≥20% <20% (32% 0.079) not significant. None other factors (surgical procedure, tumor location, use chemotherapy, taxane-based chemoradiation, or smoking history) associated complications. hospital stay 17 days 12 did (p 0.08) Conclusion The multimodality therapy may require minimization irradiation to levels lower than previously expected. Radiotherapy techniques that decrease significantly reduce risk potentially life-threatening complication.