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Dose-volume analysis for respiratory toxicity in intrathoracic esophageal cancer patients treated with definitive chemoradiotherapy using extended fields

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Title: Dose-volume analysis for respiratory toxicity in intrathoracic esophageal cancer patients treated with definitive chemoradiotherapy using extended fields
Authors: Tanabe, Satoshi Browse this author
Myojin, Miyako Browse this author
Shimizu, Shinichi Browse this author →KAKEN DB
Fujino, Masaharu Browse this author
Takahashi, Hiroaki Browse this author
Shirato, Hiroki Browse this author →KAKEN DB
Ito, Yoichi M. Browse this author
Ishikawa, Masayori Browse this author →KAKEN DB
Hosokawa, Masao Browse this author
Keywords: radiation pneumonitis
chemoradiation
esophageal cancer
dose-volume histogram
extended-field
dosimetric parameter
Issue Date: Nov-2013
Publisher: Oxford univ press
Journal Title: Journal of radiation research
Volume: 54
Issue: 6
Start Page: 1085
End Page: 1094
Publisher DOI: 10.1093/jrr/rrt047
PMID: 23660276
Abstract: Purpose: We evaluated the relationship between dosimetric parameters (DPs) and the incidence of radiation pneumonitis (RP) and investigated the feasibility of a proposed treatment planning technique with the potential of reducing RP in esophageal cancer patients treated with definitive chemoradiotherapy using extended fields. Patients and Methods: A total of 149 patients with locally advanced esophageal cancer were prospectively enrolled for extended-field radiotherapy (EFRT) to three-field regional lymphatics between September 2004 and June 2009. We retrospectively reviewed 86 consecutive patients who were treated with a total dose of 50.4 Gy (plus an optional 9 Gy boost) and were available for dose-volume analysis. Lung DPs of patients in the Grade 0-1 RP (RPG < 1) group and the Grade 2-5 RP (RPG >= 2) group were compared. We compared the proposed plan with the conventional plan to 50.4 Gy on DPs for each case. Results: Of these 86 patients, 10 (12%) developed RPG >= 2 (Grade 2, n = 2 patients; Grade 3, n = 3; Grade 4, n = 3; Grade 5, n = 2). The patients in the RPG < 1 group showed significantly lower (P < 0.05) V5 and V10 values for the whole lung compared with those in the RPG >= 2 group. There were two advantages gained from the proposed plan for V5 (< 55%) and V10 (< 37%) values and the conformity of the PTV. Conclusion: The increase in the volume of the lung exposed to low doses of EFRT was found to be associated with the incidence of RP. Our proposed plan is likely to reduce the incidence of RP.
Rights: http://creativecommons.org/licenses/by/3.0/
Type: article
URI: http://hdl.handle.net/2115/54116
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 清水 伸一

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