Reduction of heart volume during neoadjuvant chemoradiation in patients with resectable esophageal cancer

Mohammad, Nadia Haj; Kamphuis, M.; Hulshof, Maarten C.C.M.; Lutkenhaus, Lotte J.; Gisbertz, Suzanne S.; Bergman, Jacques; Bruin-Bon, H.A.C.M. Rianne de; Geijsen, Elisabeth D.; Bel, Arjan; Boekholdt, S. Matthijs; Laarhoven, Hanneke W. M. van

doi:10.1016/j.radonc.2014.12.005

Cited by 16 publications

(18 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The third frequent change observed was a reduction of heart volume. Lutkenhaus et al [15] and Mohammad et al [16] evaluated this reduction and found a significant reduction of the median heart volume of 8% over the radiotherapy treatment course. In the current study the reduction of heart volume was estimated in a similar way as Lutkenhaus et al and Mohammad et al, and was found to be 6%.…”

Section: Cbct (Original Clipbox)mentioning

confidence: 98%

Cone-Beam CT-based position verification for oesophageal cancer: Evaluation of registration methods and anatomical changes during radiotherapy

Nunen

Sangen

Boxtel

et al. 2017

Technical Innovations & Patient Support in Radiation Oncolo

View full text Add to dashboard Cite

To evaluate different registration methods, setup margins and number of corrections for CBCT-based position verification for oesophageal cancer and to evaluate anatomical changes during the course of radiotherapy treatment. Methods: From 50 patients, 440 CBCT-scans were registered automatically using a soft tissue or bone registration algorithm and compared to the clinical match. Moreover, relevant anatomical changes were monitored. A sub-analysis was performed to evaluate if tumour location influenced setup variations. Margin calculation was performed and the number of setup corrections was estimated. Results were compared to a patient group previously treated with MV-EPID based position verification. Results: CBCT-based setup variations were smaller than EPID-based setup variations, resulting in smaller setup margins of 5.9 mm (RL), 7.5 mm (CC) and 4.7 mm (AP) versus 6.0 mm, 7.8 mm and 5.5 mm, respectively. A reduction in average number of setup corrections per patient was found from 0.75 to 0.36. From all automatically registered CBCT-scans, a clipbox around PTV and vertebras combined with soft tissue registration resulted in the smallest setup margins of 5.9 mm (RL), 7.7 mm (CC), 4.8 mm (AP) and smallest average number of corrections of 0.38. For distally located tumours, a setup margin of 7.7 mm (CC) was required compared to 5.6 mm for proximal tumours. Reduction of GTV volume, heart volume and change in diaphragm position were observed in 16, 10 and 15 patients, respectively. Conclusions: CBCT-based setup variations are smaller than EPID-based variations and vary according to tumour location. When using kV-CBCT a large variety of anatomical changes is revealed, which cannot be observed with MV-EPID.

show abstract

Section: Cbct (Original Clipbox)mentioning

confidence: 98%

Cone-Beam CT-based position verification for oesophageal cancer: Evaluation of registration methods and anatomical changes during radiotherapy

Nunen

Sangen

Boxtel

et al. 2017

Technical Innovations & Patient Support in Radiation Oncolo

View full text Add to dashboard Cite

show abstract

“…Using cone beam computed tomography (CBCT), Haj et al prospectively investigated the changes in cardiac volume in esophageal cancer patients treated with neoadjuvant chemoradiation. The authors found that the cardiac volume was reduced in the early stage (41.4 Gy/1.8 Gy per fraction) of radiotherapy [ 13 ]. However, delineating soft tissue on CBCT is challenging, as the image quality is poorer than that of computed tomography (CT), and not all separate heart components are distinguishable by CBCT [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Changes in cardiac volume determined with repeated enhanced 4DCT during chemoradiotherapy for esophageal cancer

Wang

et al. 2018

Radiat Oncol

View full text Add to dashboard Cite

BackgroundConcurrent chemoradiotherapy is considered curative intent treatment for patients with non-operative esophageal cancer. Radiation-induced heart damage receives much attention. We performed repeated four-dimensional computed tomography (4DCT) to detect changes in cardiac volume during radiotherapy for esophageal cancer patients, and explored potential factors responsible for those changes.MethodsForty-six patients with esophageal cancer underwent enhanced 4DCT and three-dimensional (3D) CT scans before radiotherapy and every 10 fractions during treatment. The heart was contoured on 3DCT images, 4DCT end expiratory (EE) images and 4DCT maximum intensity projection (MIP) images by the same radiation oncologist. Heart volumes and other relative parameters were compared by the SPSS software package, version 19.0.ResultsCompared with its initial value, heart volume was smaller at the 10th fraction (reduction = 3.27%, 4.45% and 4.52% on 3DCT, EE and MIP images, respectively, p < 0.05) and the 20th fraction (reduction = 6.05%, 5.64% and 4.51% on 3DCT, EE and MIP images, respectively, p < 0.05), but not at the 30th fraction. Systolic and diastolic blood pressures were reduced (by 16.95 ± 16.69 mmHg and 7.14 ± 11.64 mmHg, respectively, both p < 0.05) and the heart rate was elevated by 5.27 ± 6.25 beats/min (p < 0.05) after radiotherapy. None of the potential explanatory variables correlated with heart volume changes.ConclusionsCardiac volume reduced significantly from an early treatment stage and maintained the reduction until the middle stage. The heart volume changes observed on 3DCT and 4DCT were consistent during radiotherapy. The changes in heart volume, blood pressure and heart rate may be valuable indicators of cardiac impairment and target dose changes.

show abstract

“…It could be argued that the cardiotoxicity observed in the present study may be due, at least in part, to carboplatin, the co-administered chemotherapeutic agent. Several publications have reported potential subtle cardiotoxic effects of carboplatin when administered in combination with paclitaxel [ 23 – 25 ].…”

Section: Resultsmentioning

confidence: 99%

The impact of paclitaxel and carboplatin chemotherapy on the autonomous nervous system of patients with ovarian cancer

et al. 2016

View full text Add to dashboard Cite

BackgroundPaclitaxel-based regimens are frequently associated with the development of peripheral neuropathy. The autonomous nervous system (ANS) effects, however, of this chemotherapeutic agent remain unexplored.MethodsWe investigated a group of 31 female patients with ovarian cancer receiving treatment with paclitaxel and carboplatin, as well as a group of 16 healthy age- and gender-matched healthy volunteers. All study participants completed a questionnaire and were assessed neurophysiologically at three time points (baseline, 3–4 months and 6–8 months following the onset of chemotherapy). The evaluation of the ANS included assessment of the adrenergic cardiovascular function (orthostatic hypotension-OH), parasympathetic heart innervation (30/15 ratio) and sympathetic skin response (SSR).ResultsAt the 3–4 months ANS assessment, 19.2 % of the patients had systolic OH and the same percentage had diastolic OH, but at the 6–8 months evaluation no patient had systolic OH and only 13.8 % had diastolic OH. The values of the 30/15 ratio were significantly reduced at both time points, whereas the SSR was not affected.ConclusionsCombined paclitaxel and carboplatin chemotherapy is associated with significant effects on the parasympathetic heart innervation and occasionally with effects on the adrenergic cardiovascular reaction. The SSR remained unaffected. Physicians should be alert to the possibility of these treatment-emergent side effects, so as to monitor ANS parameters and introduce treatment modifications accordingly. Our findings however, should be validated in larger cohorts.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-016-0710-4) contains supplementary material, which is available to authorized users.

show abstract

Reduction of heart volume during neoadjuvant chemoradiation in patients with resectable esophageal cancer

Cited by 16 publications

References 18 publications

Cone-Beam CT-based position verification for oesophageal cancer: Evaluation of registration methods and anatomical changes during radiotherapy

Cone-Beam CT-based position verification for oesophageal cancer: Evaluation of registration methods and anatomical changes during radiotherapy

Changes in cardiac volume determined with repeated enhanced 4DCT during chemoradiotherapy for esophageal cancer

The impact of paclitaxel and carboplatin chemotherapy on the autonomous nervous system of patients with ovarian cancer

Contact Info

Product

Resources

About