Dose–response relations for stricture in the proximal oesophagus from head and neck radiotherapy

• Published in: Radiotherapy and oncology 2010, Vol.97 (1), p.54-59
• Main Authors: Alevronta, Eleftheria, Ahlberg, Alexander, Mavroidis, Panayiotis, al-Abany, Massoud, Friesland, Signe, Tilikidis, Aris, Laurell, Göran, Lind, Bengt K
• Format: Article
• Language: English
• Subjects: Aged; Case-Control Studies; Dose-response parameters; Dose-Response Relationship, Radiation; Esophageal Stenosis - epidemiology; Esophageal Stenosis - etiology; Esophagus - radiation effects; Female; Fysiologi och farmakologi; Head and Neck Neoplasms - radiotherapy; Head and neck radiotherapy; Hematology, Oncology and Palliative Medicine; Humans; Male; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Middle Aged; Normal tissue complication probability; Physiology and pharmacology; Proximal oesophagus; Radiation Injuries - epidemiology; Radiological research; Radiologisk forskning; Radiotherapy - adverse effects; Radiotherapy Dosage; Retrospective Studies; Stricture; Sweden - epidemiology
• ISSN: 0167-8140; 1879-0887; 1879-0887
• DOI: 10.1016/j.radonc.2010.04.021

Abstract Background and purpose Determination of the dose–response relations for oesophageal stricture after radiotherapy of the head and neck. Material and methods In this study 33 patients who developed oesophageal stricture and 39 patients as controls are included. The patients received radiation therapy for head and neck cancer at Karolinska University Hospital, Stockholm, Sweden. For each patient the 3D dose distribution delivered to the upper 5 cm of the oesophagus was analysed. The analysis was conducted for two periods, 1992–2000 and 2001–2005, due to the different irradiation techniques used. The fitting has been done using the relative seriality model. Results For the treatment period 1992–2005, the mean doses were 49.8 and 33.4 Gy, respectively, for the cases and the controls. For the period 1992–2000, the mean doses for the cases and the controls were 49.9 and 45.9 Gy and for the period 2001–2005 were 49.8 and 21.4 Gy. For the period 2001–2005 the best estimates of the dose–response parameters are D50 = 61.5 Gy (52.9–84.9 Gy), γ = 1.4 (0.8–2.6) and s = 0.1 (0.01–0.3). Conclusions Radiation-induced strictures were found to have a dose response relation and volume dependence (low relative seriality) for the treatment period 2001–2005. However, no dose response relation was found for the complete material.