Effect of hyperthermia on radiation pneumonitis in elderly patients with esophageal cancer receiving intensity-modulated radiation therapy
10.3760/cma.j.cn113030-20230905-00086
- VernacularTitle:深部热疗对老年食管癌调强放疗患者放射性肺炎的影响
- Author:
Mengjiao WANG
1
;
Shengdong CHEN
;
Guomin ZHU
;
Yang JIAO
;
Juying ZHOU
;
Songbing QIN
;
Lili WANG
Author Information
1. 苏州大学附属第一医院放疗科，苏州 215006
- Keywords:
Radiotherapy;
Hyperthermia;
Radiation pneumonitis;
Esophageal neoplasms;
Propensity score matching
- From:
Chinese Journal of Radiation Oncology
2024;33(3):218-225
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of hyperthermia on radiation pneumonitis (RP) in elderly patients with esophageal cancer undergoing intensity-modulated radiotherapy (IMRT).Methods:Clinical data of 177 elderly esophageal cancer patients (aged ≥60 years) receiving IMRT in the First Affiliated Hospital of Soochow University and Yixing Cancer Hospital from August 1, 2017 to February 6, 2023 were retrospectively analyzed. Patients were divided into the hyperthermia and non-hyperthermia groups based on whether they received hyperthermia treatment. Patients in two groups received IMRT with 6 MV X-rays. Patients in the hyperthermia group underwent high-frequency hyperthermia within 1 h before radiation using the external thermotherapy device HG-2000Ⅲ (heating temperature: 41-43 ℃ for 40 min, twice a week). After adjusting for confounding factors between two groups using propensity score matching (PSM), the short-term effective rates between two groups were compared using Chi-square test. Univariate analysis and logistic multivariate analysis were employed to compare the incidence of RP between two groups. Results:After applying PSM, 42 pairs were successfully matched, and the baseline data and radiotherapy parameters showed no statistically significant differences between two groups (all P>0.05). The objective response rate (ORR) in the hyperthermia group was significantly higher than that in the non-hyperthermia group (83.3% vs. 64.3%, P=0.047). Univariate analysis revealed that the incidence of RP and symptomatic RP (≥ grade 2) in the hyperthermia group was significantly lower than that in the non-hyperthermia group (61.9% vs. 85.7%, P=0.013; 21.4% vs. 47.6%, P=0.012). Logistic multivariate analysis indicated that hyperthermia was an independent protective factor for symptomatic RP ( P=0.011). Conclusions:The incidence and severity of RP in elderly esophageal cancer patients receiving IMRT can be reduced by hyperthermia. Hyperthermia, as a clinically beneficial green treatment, improves efficacy and reduces toxicity for patients with esophageal cancer.
