PMID- 34128129 OWN - NLM STAT- MEDLINE DCOM- 20220325 LR - 20220325 IS - 1612-9067 (Electronic) IS - 1612-9059 (Linking) VI - 18 IP - 4 DP - 2021 Oct TI - Modeling the risk of radiation pneumonitis in esophageal squamous cell carcinoma treated with definitive chemoradiotherapy. PG - 861-871 LID - 10.1007/s10388-021-00860-y [doi] AB - BACKGROUND: To develop and validate a nomogram for the prediction of symptomatic radiation pneumonitis (RP) in patients with esophageal squamous cell carcinoma (ESCC) who received definitive concurrent chemoradiotherapy. METHODS: Clinical factors, dose-volume histogram parameters, and pulmonary function parameters were collected from 402 ESCC patients between 2010 and 2017, including 321 patients in the primary cohort and 81 in the validation cohort. The end-point was the occurrence of symptomatic RP (grade >/= 2) within the first 12 months after radiotherapy. Univariate and multivariate logistic regression analyses were applied to evaluate the predictive value of each factor for RP. A prediction model was generated in the primary cohort, which was internally validated to assess its performance. RESULTS: In the primary cohort, 31 patients (9.7%) experienced symptomatic RP. Based on logistic regression model, patients with larger planning target volumes (PTVs) or higher lung V(20) had a higher predictive risk of RP, whereas the overall risk was substantially higher for three-dimensional conformal radiotherapy (3DCRT) than intensity-modulated radiotherapy. On multivariate analysis, independent predictive factors for RP were smoking history (P = 0.035), radiotherapy modality (P < 0.001), PTV (P = 0.039), and lung V(20) (P < 0.001), which were incorporated into the nomogram. The areas under the receiver operating characteristic curve of the nomogram in the primary and validation cohorts were 0.772 and 0.900, respectively, which were superior to each predictor alone. CONCLUSIONS: Non-smoking status, 3DCRT, lung V(20) (> 27.5%), and PTV (>/= 713.0 cc) were significantly associated with a higher risk of RP. A nomogram was built with satisfactory prediction ability. CI - (c) 2021. The Japan Esophageal Society. FAU - Lan, Kaiqi AU - Lan K AD - State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou, China. AD - Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China. FAU - Xu, Cheng AU - Xu C AD - State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou, China. AD - Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou, 510060, China. FAU - Liu, Shiliang AU - Liu S AD - State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou, China. AD - Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou, 510060, China. FAU - Zhu, Jinhan AU - Zhu J AD - State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou, China. AD - Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou, 510060, China. FAU - Yang, Yadi AU - Yang Y AD - State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou, China. AD - Department of Imaging Diagnosis and Interventional Center, Sun Yat-Sen University Cancer Center, Guangzhou, China. FAU - Zhang, Li AU - Zhang L AD - State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou, China. AD - Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou, 510060, China. FAU - Guo, Suping AU - Guo S AD - State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou, China. guosp@sysucc.org.cn. AD - Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou, 510060, China. guosp@sysucc.org.cn. FAU - Xi, Mian AU - Xi M AUID- ORCID: 0000-0002-8088-0970 AD - State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou, China. ximian@sysucc.org.cn. AD - Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou, 510060, China. ximian@sysucc.org.cn. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210615 PL - Japan TA - Esophagus JT - Esophagus : official journal of the Japan Esophageal Society JID - 101206627 SB - IM MH - Chemoradiotherapy/adverse effects MH - *Esophageal Neoplasms/drug therapy/radiotherapy MH - *Esophageal Squamous Cell Carcinoma/drug therapy/radiotherapy MH - Humans MH - *Lung Neoplasms/drug therapy/pathology MH - *Radiation Pneumonitis/drug therapy/epidemiology/etiology MH - Retrospective Studies OTO - NOTNLM OT - Definitive chemoradiotherapy OT - Esophageal squamous cell carcinoma OT - Nomogram OT - Prediction model OT - Radiation pneumonitis EDAT- 2021/06/16 06:00 MHDA- 2022/03/26 06:00 CRDT- 2021/06/15 07:03 PHST- 2021/02/22 00:00 [received] PHST- 2021/06/08 00:00 [accepted] PHST- 2021/06/16 06:00 [pubmed] PHST- 2022/03/26 06:00 [medline] PHST- 2021/06/15 07:03 [entrez] AID - 10.1007/s10388-021-00860-y [pii] AID - 10.1007/s10388-021-00860-y [doi] PST - ppublish SO - Esophagus. 2021 Oct;18(4):861-871. doi: 10.1007/s10388-021-00860-y. Epub 2021 Jun 15.