Abstract
We investigated the feasibility of simultaneous integrated boost (SIB) volumetric modulated arc therapy (VMAT) using elective nodal irradiation (ENI) for middle or lower esophageal cancer and compared it with three-dimensional conformal radiotherapy (3D-CRT). The study included 15 patients. The prescribed doses included a standard dose (50.4 Gy) and a high dose (60 Gy) for the planning target volume (PTV) of the involved lesions. The objective of the whole lung volume receiving ≥ 20 Gy (V20Gy) was < 30%, and the mean lung dose (MLD) was < 20 Gy. The volumes of the lung receiving 5 Gy (V5Gy) and the heart receiving 30-50 Gy (V30-50Gy) were kept as low as reasonably achievable. As a result, SIB-VMAT showed superior dose conformity for the PTV (p<0.001). Although the lung V5Gy was significantly increased (p<0.001), the V20Gy and MLD showed no significant increase. The heart V30-50Gy showed a > 20% reduction in the mean against 3D-CRTs. Our results demonstrate the feasibility of SIB-VMAT for the treatment of middle or lower esophageal cancer with ENI. Although attention should be paid to the low-dose area of the lungs, SIB-VMAT would be a promising treatment option with improved outcomes for esophageal cancer.
| Original language | English |
|---|---|
| Pages (from-to) | 247-257 |
| Number of pages | 11 |
| Journal | Acta medica Okayama |
| Volume | 73 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jun 1 2019 |
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Keywords
- 3D-CRT
- elective nodal irradiation
- esophageal cancer
- middle and lower thoracic
- volumetric modulated arc therapy,
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)
Cite this
Simultaneous Integrated Boost Volumetric Modulated Arc Therapy for Middle or Lower Esophageal Cancer Using Elective Nodal Irradiation : Comparison with 3D Conformal Radiotherapy. / Yoshio, Kotaro; Wakita, Akihisa; Mitsuhashi, Toshiharu; Kitayama, Takahiro; Hisazumi, Kento; Inoue, Daisaku; Tajiri, Nobuhisa; Shiode, Tsuyoki; Akaki, Shiro; Kanazawa, Susumu.
In: Acta medica Okayama, Vol. 73, No. 3, 01.06.2019, p. 247-257.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Simultaneous Integrated Boost Volumetric Modulated Arc Therapy for Middle or Lower Esophageal Cancer Using Elective Nodal Irradiation
T2 - Comparison with 3D Conformal Radiotherapy
AU - Yoshio, Kotaro
AU - Wakita, Akihisa
AU - Mitsuhashi, Toshiharu
AU - Kitayama, Takahiro
AU - Hisazumi, Kento
AU - Inoue, Daisaku
AU - Tajiri, Nobuhisa
AU - Shiode, Tsuyoki
AU - Akaki, Shiro
AU - Kanazawa, Susumu
PY - 2019/6/1
Y1 - 2019/6/1
N2 - We investigated the feasibility of simultaneous integrated boost (SIB) volumetric modulated arc therapy (VMAT) using elective nodal irradiation (ENI) for middle or lower esophageal cancer and compared it with three-dimensional conformal radiotherapy (3D-CRT). The study included 15 patients. The prescribed doses included a standard dose (50.4 Gy) and a high dose (60 Gy) for the planning target volume (PTV) of the involved lesions. The objective of the whole lung volume receiving ≥ 20 Gy (V20Gy) was < 30%, and the mean lung dose (MLD) was < 20 Gy. The volumes of the lung receiving 5 Gy (V5Gy) and the heart receiving 30-50 Gy (V30-50Gy) were kept as low as reasonably achievable. As a result, SIB-VMAT showed superior dose conformity for the PTV (p<0.001). Although the lung V5Gy was significantly increased (p<0.001), the V20Gy and MLD showed no significant increase. The heart V30-50Gy showed a > 20% reduction in the mean against 3D-CRTs. Our results demonstrate the feasibility of SIB-VMAT for the treatment of middle or lower esophageal cancer with ENI. Although attention should be paid to the low-dose area of the lungs, SIB-VMAT would be a promising treatment option with improved outcomes for esophageal cancer.
AB - We investigated the feasibility of simultaneous integrated boost (SIB) volumetric modulated arc therapy (VMAT) using elective nodal irradiation (ENI) for middle or lower esophageal cancer and compared it with three-dimensional conformal radiotherapy (3D-CRT). The study included 15 patients. The prescribed doses included a standard dose (50.4 Gy) and a high dose (60 Gy) for the planning target volume (PTV) of the involved lesions. The objective of the whole lung volume receiving ≥ 20 Gy (V20Gy) was < 30%, and the mean lung dose (MLD) was < 20 Gy. The volumes of the lung receiving 5 Gy (V5Gy) and the heart receiving 30-50 Gy (V30-50Gy) were kept as low as reasonably achievable. As a result, SIB-VMAT showed superior dose conformity for the PTV (p<0.001). Although the lung V5Gy was significantly increased (p<0.001), the V20Gy and MLD showed no significant increase. The heart V30-50Gy showed a > 20% reduction in the mean against 3D-CRTs. Our results demonstrate the feasibility of SIB-VMAT for the treatment of middle or lower esophageal cancer with ENI. Although attention should be paid to the low-dose area of the lungs, SIB-VMAT would be a promising treatment option with improved outcomes for esophageal cancer.
KW - 3D-CRT
KW - elective nodal irradiation
KW - esophageal cancer
KW - middle and lower thoracic
KW - volumetric modulated arc therapy,
UR - http://www.scopus.com/inward/record.url?scp=85068765142&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068765142&partnerID=8YFLogxK
U2 - 10.18926/AMO/56868
DO - 10.18926/AMO/56868
M3 - Article
C2 - 31235973
AN - SCOPUS:85068765142
VL - 73
SP - 247
EP - 257
JO - Acta Medica Okayama
JF - Acta Medica Okayama
SN - 0386-300X
IS - 3
ER -