Does cumulative oesophageal dose and concurrent chemotherapy increase the risk of grade 3 or worse oesophageal toxicity in patients undergoing thoracic re-irradiation?
A cumulative oesophageal dose constraint of <95 Gy3 EQD2 without chemotherapy limits ≥G3 toxicity to under 5% in thoracic re-irradiation, while concurrent chemotherapy significantly increases toxicity risk.
Background and purpose: Re-irradiation (re-RT) in recurrent thoracic cancer is being performed more often and can cause severe toxicity. Information is lacking on safe re-irradiation dose constraints. We modelled the relationship between cumulative oesophageal dose and grade 3 or worse (≥G3) oesophageal toxicity to develop dose constraints. Materials and methods: associated with a 5% ≥G3 toxicity rate. Model performance was assessed using the Pearson correlation coefficient (PCC). Results: (95% CI: 79.6, 142.8) respectively. The model had a PCC of 0.75 (p = 0.013) suggesting good correlation to the dataset. Conclusion: EQD2). ConCT with re-irradiation has a large radiosensitising effect. Limitations of this study include the use of old, retrospective data resulting in wide CIs around the predictions and insufficient data to predict a volumetric constraint. Further modelling with more detailed dose data is required to refine and validate these predictions.
Rulach et al. (Thu,) studied this question.
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