Simultaneous Integrated Boost Volumetric Modulated Arc Therapy for Middle or Lower Esophageal Cancer Using Elective Nodal Irradiation: Comparison with 3D Conformal Radiotherapy

Kotaro Yoshio, Akihisa Wakita, Toshiharu Mitsuhashi, Takahiro Kitayama, Kento Hisazumi, Daisaku Inoue, Nobuhisa Tajiri, Tsuyoki Shiode, Shiro Akaki, Susumu Kanazawa

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 languageEnglish
Pages (from-to)247-257
Number of pages11
JournalActa medica Okayama
Volume73
Issue number3
DOIs
Publication statusPublished - Jun 1 2019

Fingerprint

Conformal Radiotherapy
Intensity-Modulated Radiotherapy
Cathode ray tubes
Radiotherapy
Esophageal Neoplasms
Irradiation
Lung
Planning
Therapeutics

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 journalArticle

Yoshio, Kotaro ; Wakita, Akihisa ; Mitsuhashi, Toshiharu ; Kitayama, Takahiro ; Hisazumi, Kento ; Inoue, Daisaku ; Tajiri, Nobuhisa ; Shiode, Tsuyoki ; Akaki, Shiro ; Kanazawa, Susumu. / Simultaneous Integrated Boost Volumetric Modulated Arc Therapy for Middle or Lower Esophageal Cancer Using Elective Nodal Irradiation : Comparison with 3D Conformal Radiotherapy. In: Acta medica Okayama. 2019 ; Vol. 73, No. 3. pp. 247-257.
@article{323c215e3ace470bad77e835cf11ab6e,
title = "Simultaneous Integrated Boost Volumetric Modulated Arc Therapy for Middle or Lower Esophageal Cancer Using Elective Nodal Irradiation: Comparison with 3D Conformal Radiotherapy",
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.",
keywords = "3D-CRT, elective nodal irradiation, esophageal cancer, middle and lower thoracic, volumetric modulated arc therapy,",
author = "Kotaro Yoshio and Akihisa Wakita and Toshiharu Mitsuhashi and Takahiro Kitayama and Kento Hisazumi and Daisaku Inoue and Nobuhisa Tajiri and Tsuyoki Shiode and Shiro Akaki and Susumu Kanazawa",
year = "2019",
month = "6",
day = "1",
doi = "10.18926/AMO/56868",
language = "English",
volume = "73",
pages = "247--257",
journal = "Acta Medica Okayama",
issn = "0386-300X",
publisher = "Okayama University",
number = "3",

}

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 -