Objective:To study the incidence and related predictive factors for acute esophagitis in patients with locally advanced non-small cell lung cancer(NSCLC)treated with intensity modulated radiation(IMRT)con-current chemotherapy.Methods:Data were collected retrospectively from 156 patients with inoperable or unresect-able stage Ⅲ NSCLC treated in our hospital between January 2010 and December 2016.The radiotherapy target vol-ume included primary lung cancer and lymphatic drainage area involved,with a median dose of 60 Gy in 30 fractions (50-70Gy).Grade ≥ 2 acute esophagitis(AE)which occurred during radiotherapy and within 3 months after com-pletion of radiotherapy served as the outcome event.National Cancer Institute Common Terminology Criteria for Ad-verse Events version 3.0(NCI-CTCA3.0)was used to evaluated the grade of AE.The logistic regression model was used to analyze the predictive factors.Results:A total of 122 patients(78.2%)had treatment-related grade ≥2AE;99 patients(63.5%)had grade 2 AE and 23 patients(14.7%)had grade 3 AE.The median dose when grade ≥2 AE occurred was 26 Gy(8-64Gy).For grade ≥2 AE,multivariate analysis showed that esophageal V 5-V60,mean dose,and age were independent predictive factors(P=0.021,0,0.010).Old age and higher BMI were the predictive factors.Conclusions For patients with locally advanced NSCLC treated with IMRT concurrent chemotherapy,esoph-ageal V50 are high predictive value for grade ≥2AE.%目的:研究局部晚期非小细胞肺癌(NSCLC)患者强调放射治疗(IM RT)合并化疗时急性食管炎的发生率及相关预测因素.方法:收集IM RT 同步化疗未手术Ⅲ期NSCLC 患者156例.放疗靶区包括原发肺肿瘤及受累淋巴引流区,中位剂量为60Gy,分30次(50~70Gy).放疗期间及放疗结束后3个月内出现≥2级急性食管炎作为终点事件,采用 CTCAE3.0评估急性食管炎级别,并采用Logistic回归模型对预测因素进行分析.结果:156例中,出现治疗相关≥2级急性食管炎122例(78.2%),其中2级99例(63.5%)、3级23例(14.7%);≥2级急性食管炎发生时的中位剂量为26Gy(8~64 Gy);食管V5-V60、食管平均剂量及年龄是≥2级急性食管炎的预测因素(P=0.019、0.0.0.02),其中高龄和高体重指数是保护性因素.结论:局部晚期NSCLC 患者IM-RT 同步化疗时,食管V50对预测≥2级急性食管炎有较高价值.
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