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Evaluating the relationship between dosimetric parameters and esophagitis in patients who experienced radiotherapy in the cervicothoracic region

Purpose: Prescribing radiotherapy or concurrent chemoradiation for cervicothoracic cancers inevitably leads to esophagitis. The purpose of the current study was to evaluate the correlation between the dose–volume parameters and the esophagitis in patients who received radiotherapy in the cervicothoracic region. Materials and Methods: Forty cancerous patients whose radiotherapy fields were in the cervicothoracic region have been rolled. The correlation between the dosimetric and clinical factors with esophagitis was analyzed through binary logistic regression model and Pearson correlation tests and was quantified with receiver operating characteristic curve. Results: The patients participating in the study were selected from breast (6 cases), lymphoma (7 cases), and head-neck (27 cases) patients with prescription doses of 36–72 Gy. Increasing esophagus mean dose resulted in an increase of acute esophagitis significantly (P = 0.05). Furthermore, by one-gray increase in the esophagus median dose, the possibility of esophagitis increased by 9.3% (P = 0.02). To prevent acute esophagitis (Grade ≥2), D50 should be kept below 7 Gy. To limit acute esophagitis, V40 should be kept below 19% (P = 0.04). Conclusions: Based on the correlation analysis of the current study, concurrent chemoradiotherapy, DMean, D50, D80, and V40 are known as reliable predictive dosimetric parameters of acute esophagitis incidence in patients who experienced radiotherapy in the cervicothoracic region.