Three-dimensional conformal radiation for esophageal squamous cell carcinoma with involved-field irradiation may deliver considerable doses of incidental nodal irradiation
<p>Abstract</p> <p>Background</p> <p>To quantify the incidental irradiation dose to esophageal lymph node stations when irradiating T1-4N0M0 thoracic esophageal squamous cell carcinoma (ESCC) patients with a dose of 60 Gy/30f.</p> <p>Methods</p> <p&...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-11-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.ro-journal.com/content/7/1/200 |
| _version_ | 1818491711117066240 |
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| author | Ji Kai Zhao Lujun Yang Chengwen Meng Maobin Wang Ping |
| author_facet | Ji Kai Zhao Lujun Yang Chengwen Meng Maobin Wang Ping |
| author_sort | Ji Kai |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>To quantify the incidental irradiation dose to esophageal lymph node stations when irradiating T1-4N0M0 thoracic esophageal squamous cell carcinoma (ESCC) patients with a dose of 60 Gy/30f.</p> <p>Methods</p> <p>Thirty-nine patients with medically inoperable T1–4N0M0 thoracic ESCC were treated with three-dimensional conformal radiation (3DCRT) with involved-field radiation (IFI). The conformal clinical target volume (CTV) was re-created using a 3-cm margin in the proximal and distal direction beyond the barium esophagogram, endoscopic examination and CT scan defined the gross tumor volume (GTV) and a 0.5-cm margin in the lateral and anteroposterior directions of the CT scan-defined GTV. The PTV encompassed 1-cm proximal and distal margins and 0.5-cm radial margin based on the CTV. Nodal regions were delineated using the Japanese Society for Esophageal Diseases (JSED) guidelines and an EORTC-ROG expert opinion. The equivalent uniform dose (EUD) and other dosimetric parameters were calculated for each nodal station. Nodal regions with a metastasis rate greater than 5% were considered a high-risk lymph node subgroup.</p> <p>Results</p> <p>Under a 60 Gy dosage, the median D<sub>mean</sub> and EUD was greater than 40 Gy in most high-risk nodal regions except for regions of 104, 106tb-R in upper-thoracic ESCC and 101, 104-R, 105, 106rec-L, 2, 3&7 in middle-thoracic ESCC and 107, 3&7 in lower-thoracic ESCC. In the regions with an EUD less than 40Gy, most incidental irradiation doses were significantly associated with esophageal tumor length and location.</p> <p>Conclusions</p> <p>Lymph node stations near ESCC receive considerable incidental irradiation doses with involved-field irradiation that may contribute to the elimination of subclinical lesions.</p> |
| first_indexed | 2024-12-10T17:34:36Z |
| format | Article |
| id | doaj.art-28f17fe4876c4a3abafef2dfd3f4b35b |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-10T17:34:36Z |
| publishDate | 2012-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-28f17fe4876c4a3abafef2dfd3f4b35b2022-12-22T01:39:35ZengBMCRadiation Oncology1748-717X2012-11-017120010.1186/1748-717X-7-200Three-dimensional conformal radiation for esophageal squamous cell carcinoma with involved-field irradiation may deliver considerable doses of incidental nodal irradiationJi KaiZhao LujunYang ChengwenMeng MaobinWang Ping<p>Abstract</p> <p>Background</p> <p>To quantify the incidental irradiation dose to esophageal lymph node stations when irradiating T1-4N0M0 thoracic esophageal squamous cell carcinoma (ESCC) patients with a dose of 60 Gy/30f.</p> <p>Methods</p> <p>Thirty-nine patients with medically inoperable T1–4N0M0 thoracic ESCC were treated with three-dimensional conformal radiation (3DCRT) with involved-field radiation (IFI). The conformal clinical target volume (CTV) was re-created using a 3-cm margin in the proximal and distal direction beyond the barium esophagogram, endoscopic examination and CT scan defined the gross tumor volume (GTV) and a 0.5-cm margin in the lateral and anteroposterior directions of the CT scan-defined GTV. The PTV encompassed 1-cm proximal and distal margins and 0.5-cm radial margin based on the CTV. Nodal regions were delineated using the Japanese Society for Esophageal Diseases (JSED) guidelines and an EORTC-ROG expert opinion. The equivalent uniform dose (EUD) and other dosimetric parameters were calculated for each nodal station. Nodal regions with a metastasis rate greater than 5% were considered a high-risk lymph node subgroup.</p> <p>Results</p> <p>Under a 60 Gy dosage, the median D<sub>mean</sub> and EUD was greater than 40 Gy in most high-risk nodal regions except for regions of 104, 106tb-R in upper-thoracic ESCC and 101, 104-R, 105, 106rec-L, 2, 3&7 in middle-thoracic ESCC and 107, 3&7 in lower-thoracic ESCC. In the regions with an EUD less than 40Gy, most incidental irradiation doses were significantly associated with esophageal tumor length and location.</p> <p>Conclusions</p> <p>Lymph node stations near ESCC receive considerable incidental irradiation doses with involved-field irradiation that may contribute to the elimination of subclinical lesions.</p>http://www.ro-journal.com/content/7/1/200Esophageal squamous cell carcinomaRadiotherapyIncidental irradiation |
| spellingShingle | Ji Kai Zhao Lujun Yang Chengwen Meng Maobin Wang Ping Three-dimensional conformal radiation for esophageal squamous cell carcinoma with involved-field irradiation may deliver considerable doses of incidental nodal irradiation Radiation Oncology Esophageal squamous cell carcinoma Radiotherapy Incidental irradiation |
| title | Three-dimensional conformal radiation for esophageal squamous cell carcinoma with involved-field irradiation may deliver considerable doses of incidental nodal irradiation |
| title_full | Three-dimensional conformal radiation for esophageal squamous cell carcinoma with involved-field irradiation may deliver considerable doses of incidental nodal irradiation |
| title_fullStr | Three-dimensional conformal radiation for esophageal squamous cell carcinoma with involved-field irradiation may deliver considerable doses of incidental nodal irradiation |
| title_full_unstemmed | Three-dimensional conformal radiation for esophageal squamous cell carcinoma with involved-field irradiation may deliver considerable doses of incidental nodal irradiation |
| title_short | Three-dimensional conformal radiation for esophageal squamous cell carcinoma with involved-field irradiation may deliver considerable doses of incidental nodal irradiation |
| title_sort | three dimensional conformal radiation for esophageal squamous cell carcinoma with involved field irradiation may deliver considerable doses of incidental nodal irradiation |
| topic | Esophageal squamous cell carcinoma Radiotherapy Incidental irradiation |
| url | http://www.ro-journal.com/content/7/1/200 |
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