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Thumnail 73_3_247.pdf 9.12 MB
Author
Yoshio, Kotaro Department of Radiology, Kagawa Prefectural Central Hospital
Wakita, Akihisa Division of Medical Physics, Euro MediTech Co. Ltd
Mitsuhashi, Toshiharu Center for Innovative Clinical Medicine, Okayama University Hospital
Kitayama, Takahiro Department of Radiology, Kagawa Prefectural Central Hospital
Hisazumi, Kento Department of Radiology, Kagawa Prefectural Central Hospital
Inoue, Daisaku Department of Radiology, Kagawa Prefectural Central Hospital
Tajiri, Nobuhisa Department of Radiology, Kagawa Prefectural Central Hospital
Shiode, Tsuyoki Department of Radiology, Kagawa Prefectural Central Hospital
Akaki, Shiro Department of Radiology, Kagawa Prefectural Central Hospital
Kanazawa, Susumu Department of Radiology, Okayama University Hospital
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
esophageal cancer
middle and lower thoracic
volumetric modulated arc therapy,
3D-CRT
elective nodal irradiation
Amo Type
Original Article
Published Date
2019-06
Publication Title
Acta Medica Okayama
Volume
volume73
Issue
issue3
Publisher
Okayama University Medical School
Start Page
247
End Page
257
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
英語
Copyright Holders
CopyrightⒸ 2019 by Okayama University Medical School
File Version
publisher
Refereed
True
PubMed ID