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Year : 2022  |  Volume : 18  |  Issue : 6  |  Page : 1706-1715

Radiobiological modeling of acute esophagitis after radiation therapy of head, neck, and thorax tumors: The influence of chemo-radiation

1 Molecular Medicine Research Center, Institute of Biomedicine; Medical Radiation Sciences Research Team; Medical Physics Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
2 Radiology and Radiotherapy Department, Medical School, Tabriz University of Medical Science, Tabriz, Iran
3 Road Traffic Injury Research Center; Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
4 Department of Radiology and Radiation Oncology, University of Mississippi Medical Center (UMMC), Jackson, Mississippi, USA

Correspondence Address:
Asghar Mesbahi
Department of Medical Physics, Faculty of Medicine, Attare-Neishabouri Street, Tabriz University of Medical Sciences, Tabriz
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_271_20

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Aim: The aim of this study was to evaluate the performance of various radiobiological models in predicting the occurrence of acute esophagitis (AE) during radiation therapy (RT) of head, neck, and thoracic tumors with concurrent and sequential chemotherapy. According to recent studies, the probability of AE following RT by normal tissue complication probability models is predictable. Materials and Methods: A total of 100 patients with nasopharynx, larynx, Hodgkin's lymphoma, spinal metastases, and oral cavity and lung tumors were included in the study. Half of these patients were treated by concurrent chemo-radiotherapy (Con. CRT) and the other half were treated by radiotherapy alone or sequential chemo-radiotherapy (RT + seq. CRT). Radiobiological models of several types were used as follows,: Lyman-generalized equivalent uniform dose (gEUD), Lyman-MED, log-logistic, logit, and logistic. Parameters were estimated using maximum likelihood estimation, and models were compared using Akaike information criteria. Results: Based on follow-up data, the behavior of dose–response curves differed markedly between the Con. CRT and RT + seq. CRT groups. The best fit with clinical results was offered by the Lyman-MED model for the Con. CRT group and the Lyman-gEUD model for the RT + seq. CRT group. Depending on the model used, the parameter of D50 was considerably lower (up to three times) in the Con. CRT group compared to the RT + seq. CRT group. Conclusions: The incidence of AE significantly differed between the two treatment groups in all the models. New parameter estimates could be used for predicting the probability of acute esophagitis after chemo-RT.

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