Acute oesophageal toxicity related to paclitaxel-based concurrent chemoradiotherapy for non-small cell lung cancer.

Background: Dosimetric data and acute oesophageal toxicity (AET) during chemoradiotherapy (CRT) were evaluated in patients with non-small cell lung cancer (NSCLC). Patients and Methods: Fifty patients were treated with paclitaxel-based conformal CRT with a mean +/- SD dose of 60.7 +/- 9.8 Gy. The oesophageal toxicity was prospectively registered and evaluated in relation to the maximal dose (D-max), mean dose (D-mean), length and volume of oesophagus irradiated with 35-60 Gy (V35-60Gy), and according to the seriousness of AET. Results: D-max and D-mean to the oesophagus were 57.0 +/- 10.8 Gy and 24.9 +/- 9.0 Gy, respectively. AET of grade I, 2 and 3 developed in 16 (32%), 14 (28%) and three (6%) cases, respectively. The D-max, D-mean, length and the V35-60Gy were all related to dysphagia (p<0.001). V-45Gy was the most reliable predictor of AET of grade 2 or more. Conclusion: Our results indicate that keeping oesophageal V-45Gy below 32.5% can prevent severe AET during CRT of NSCLC.