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
N1 - Publisher Copyright:
© 2019 by Okayama University Medical School.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019
Y1 - 2019
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
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M3 - Article
C2 - 31235973
AN - SCOPUS:85068765142
VL - 73
SP - 247
EP - 254
JO - Acta Medica Okayama
JF - Acta Medica Okayama
SN - 0386-300X
IS - 3
ER -