Esophageal cancer: Determination of internal target volume for conformal radiotherapy

Differences in displacement of the proximal and distal ends of mid-upper thoracic esophageal squamous cell carcinoma

“…Our results demonstrated that no significant differences in displacement were found between the upper and lower clips in the LR, SI and AP directions and, thus, differential ITV margins based on different parts of the tumor are not recommended. Previous studies have investigated the displacement of tumors in various parts of the esophagus with conflicting results (9,10,(15)(16)(17). For example, in a study by Lorchel et al (16), 8 patients that presented with esophageal malignancies underwent two conventional spiral CT scans during breath-hold procedure under spirometric control, and no association of tumor motion with anatomical location was observed.…”

“…In this study, tumors located at the upper and middle thoracic esophagus were assessed, while it has been previously confirmed that tumors located in the distal esophagus are more mobile (9,10,(15)(16)(17). Therefore, a further exploratory study was performed by placing a third clip at the lower thoracic esophagus at 2 cm above the non-neoplastic GEJ to preliminarily determine whether displacement differences between the upper and lower ends of the tumor may also occur if the distal end of the tumor is located near the GEJ.…”

Implications of Respiratory Motion as Measured by Four-Dimensional Computed Tomography for Radiation Treatment Planning of Esophageal Cancer

“…Although several studies have examined the respiratory motion of tumors in the lung (8)(9)(10)(11)(12) and infradiaphragmatic organs (13)(14)(15), the literature describing esophageal tumor motion Reprint requests to: Noah C. Choi is limited. Lorchel et al (16) have reported measurements of esophageal tumor motion by acquiring CT scans during inspiratory and expiratory breath-hold for a series of 8 patients (16). Dieleman et al (17) analyzed healthy esophageal motion using normal-breathing 4D CT in 29 patients with non-esophageal thoracic malignancies (17).…”

Four-Dimensional Measurement of the Displacement of Internal Fiducial Markers During 320-Multislice Computed Tomography Scanning of Thoracic Esophageal Cancer

“…Lorchel et al(14) reported measurements of esophageal tumor motion acquired by CT scans during inspiratory and expiratory breath-hold for a series of 8 patients.Dieleman et al (4) analyzed healthy esophageal motion using normal-breathing 4D-CT in 29 patients with nonesophageal thoracic malignancies. In two recently published Metal clips' centroid trajectories in all 41 phases for 20 s of the four-dimensional CT scans.…”