To explore the effect of different dosimetric parameters after intensity modulated radiotherapy (IMRT) for esophageal cancer on the occurrence and grading of radiation pneumonia (RP).

Eighty esophageal cancer patients admitted to Jieshou People's Hospital from June 2019 to November 2023 were selected, all of whom implemented the IMRT plan. Patients were divided into RP group and non RP group based on whether they developed RP after the implementation of IMRT, and the RP group was graded according to the severity of their condition. The differences in dosimetry related indicator parameters between the RP group and the non RP group, as well as different grades of RP were compared. At the same time, logistic multiple factor analysis on dosimetry parameter data was performed to summarize the effect of different dosimetry related indicator parameters on the occurrence and severity of RP.

Among the 80 patients, 36 patients developed RP, while 44 patients did not. Among the RP patients, there were 20 grade Ⅰ patients, 13 grade Ⅱ patients, and 3 grade Ⅲ patients. The dosimetric parameters V10, V20, and MLD of the RP group were higher than those of the non RP group (P<0.05). The dosimetric parameters V10, V20, and MLD of grade Ⅲ RP patients were higher than those of grade Ⅰ and grade Ⅱ RP patients, while those of grade Ⅱ RP patients were higher than those of grade Ⅰ (P<0.05). Multivariate analysis results showed that dosimetric parameters V10, V20, and MLD were independent risk factors for RP in esophageal cancer patients after using the IMRT plan.

The occurrence of RP and the severity grading of RP after implementing the IMRT plan for esophageal cancer are related to different dosimetric parameters. Dosimetric parameters V10, V20, and MLD are the influencing factors for RP in esophageal cancer patients after implementing the IMRT plan.