Abstract

ABSTRACT Background and aims Docetaxel (DOC) is a key drug in second-line chemotherapy after the failure of chemoradiotherapy (CRT) for esophageal cancer. Interstitial pulmonary disorder (IPD) is one of the fatal adverse effects of DOC, but its frequency and risk factors have not been clarified. The aim of this study was to determine the frequency of and risk factors for IPD in patients with esophageal squamous cell carcinoma (ESCC), who were treated with DOC after the failure of CRT. Patients and methods We retrospectively reviewed the clinical data for 115 patients with ESCC who had been treated with CRT at Kyoto University Hospital from April 2007 to March 2011. Thirty-seven of these patients had been treated with DOC after CRT (D group) and 78 had not been treated with DOC (non-D group). We compared the incidence of IPD in the two groups and also identified the risk factors for IPD. Results The incidence of grade 3/4 IPD in the D and non-D groups was 10.8% (4/37) and 1.3% (1/78), respectively (P = 0.035). A median of 4 cycles of DOC was administered (range, 2–7). The median total radiation dose was 60 Gy. The mean value for V20 (% total lung volume receiving ≥20Gy) in patients with grade 3/4 IPD was greater than that in patients without IPD (20.0% vs 12.3%, respectively; P = 0.012). The V20 value was greater than 20% in 80% (4/5) of patients with grade 3/4 IPD. The mean lung dose (MLD) in patients with grade 3/4 IPD was also greater than that in patients without IPD (11.1 Gy vs 6.6 Gy, respectively; P Conclusion The incidence of grade 3/4 IPD was 10.8% in patients who received DOC after CRT. IPD must be considered when DOC is administered to patients who have already received radiotherapy with high V20 and MLD in their first-line CRT. Disclosure All authors have declared no conflicts of interest.

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