[Dosimetric factors related to postoperative pulmonary complications in locally advanced esophageal cancers treated with preoperative chemoradiotherapy: Literature review]

Abstract

Introduction: Preoperative chemoradiotherapy is an option for locally advanced esophageal cancer. Radiation therapy may increase postoperative pulmonary complications. Usual lungs dose constraints in radiotherapy are old and used by extrapolation of lung cancer management. Our objective is to review the literature on correlations between postoperative lung toxicity and dosimetric factors.

Method: This literature review identified and selected studies published between 1987 and 2019 using the PRISMA method. The articles were identified on the basis of a PubMed search and the author's knowledge, using the following terms: "esophageal cancer"; "chemoradiotherapy"; "dosimetric factors"; "postoperative pulmonary complications".

Results: Fourteen articles were selected, and five did not demonstrate a correlation between dosimetric factors and the postoperative pulmonary complications rate. The V20 (lung volume receiving more than 20Gy) was identified in three studies, like the V10, V15 and mean lung dose (around 10Gy) in two studies. The V30≥20% was identified in one study.

Discussion: The most frequently identified dosimetric predictors for postoperative pulmonary complications are the V20 and the mean lung dose. Results of prospective studies would lead us to specify which of these parameters is most relevant for predicting the risk of postoperative pulmonary complications.

Keywords: Cancer de l’œsophage; Complications postopératoires; Complications pulmonaires; Dosimetric factors; Esophageal cancer; Facteurs dosimétriques; Postoperative complication; Preoperative chemoradiotherapy; Pulmonary complication; Radiochimiothérapie préopératoire.