Prediction Factors of Radiation Esophagitis in Breast Cancer Patients Undergoing Supraclavicular Radiotherapy

The aim of this study was to investigate demographic and dosimetric parameters which may link with esophagitis in patients with breast cancer receiving three-dimensional conformal radiotherapy to the supraclavicular fossa.

We examined 27 breast cancer patients with supraclavicular metastases. All patients were treated with radiotherapy (RT) with a prescribed dose of 40.5 Gy in 15 fractions for 3 weeks. Esophagitis was recorded weekly and esophagus toxicity was evaluated and graded according to the tadiation therapy oncology group. The following factors were examined regarding their correlation with grade 1 or worse esophagitis by univariate and multivariate analyses: age, chemotherapy, smoking history, maximum dose (D_max), mean dose (D_mean), esophagus volume receiving 10 Gy (V10), esophagus volume receiving 20 Gy (V20), and length of esophagus in the treatment field.

Of 27, 11 (40.7%) patients developed no esophageal irritation throughout therapy. Approximately half of the patients 13/27 (48.1%) had maximum grade 1 esophagitis. 2/27 (7.4%) patients had grade 2 esophagitis. The incidence of grade 3 esophagitis was (3.7%). D_mean, D_max, V10, and V20 were 10.48 ± 5.10 Gy, 38.18 ± 5.12Gy, 29.83 ± 15.16, and 19.32 ± 10.01, respectively. Our results showed that D_mean, V10, and V20 were the significant factors for the development of esophagitis, whereas esophagitis was not significantly associated with the chemotherapy regimen, age, and smoking status.

We found that D_mean, V10, and V20 correlated significantly with acute esophagitis. However, the chemotherapy regimen, age, and smoking status did not affect esophagitis development.