Risk Factors for Pericardial Effusion in Inoperable Esophageal Cancer Patients Treated With Definitive Chemoradiation Therapy

Xiong, Wei; Liu, H. Helen; Tucker, Susan L.; Wang, Shulian; Mohan, Radhe; Cox, James D.; Komaki, Ritsuko; Liao, Zhongxing

doi:10.1016/j.ijrobp.2007.10.056

Cited by 162 publications

(133 citation statements)

References 28 publications

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“…There has been only one report dealing with the risk factors for the development of PCE using DVH analysis of the pericardium, and it showed a strong correlation. 11,12 To reduce damage to organs at risk, multiple field irradiation, intensity-modulated radiation therapy and proton beam therapy are used.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors for pericardial effusion identified by heart dose–volume histogram analysis in oesophageal cancer patients treated with chemoradiotherapy

Hayashi¹,

Fujiwara²,

Nomura³

et al. 2015

BJR

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with oesophageal cancer treated with chemoradiotherapy (CRT) using the following criteria were evaluated: radiation dose .50 Gy; heart included in the radiation field; dose-volume histogram (DVH) data available for analysis; no previous thoracic surgery; and no PCE before treatment. The diagnosis of PCE was independently determined by two radiologists. Clinical factors, the percentage of heart volume receiving .5-60 Gy in increments of 5 Gy (V5-60, respectively), maximum heart dose and mean heart dose were analysed. Results: A total of 143 patients with oesophageal cancer were reviewed retrospectively. The median follow-up by CT was 15 months (range, 2.1-72.6 months) after RT. PCE developed in 55 patients (38.5%) after RT, and the median time to develop PCE was 3.5 months (range, 0.2-9.9 months). On univariate analysis, DVH parameters except for V60 were significantly associated with the development of PCE (p , 0.001). No clinical factor was significantly related to the development of PCE.Recursive partitioning analysis including all DVH parameters as variables showed a V10 cut-off value of 72.8% to be the most influential factor. Conclusion:The present results showed that DVH parameters are strong independent predictive factors for the development of PCE in patients with oesophageal cancer treated with CRT. Advances in knowledge: A heart dosage was associated with the development of PCE with radiation and without prophylactic nodal irradiation.

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Section: Discussionmentioning

confidence: 99%

Predictive factors for pericardial effusion identified by heart dose–volume histogram analysis in oesophageal cancer patients treated with chemoradiotherapy

Hayashi¹,

Fujiwara²,

Nomura³

et al. 2015

BJR

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“…There are data [10] documenting clinically manifested cardiac morbidity in up to 44% of the patients, and heart irradiated to 30 Gy (V30) .46% was predictive of cardiac complications [11]. We have demonstrated a reduction in heart V40 and V45 with changes in the number and arrangement of beams in this site previously [12], using conformal planning.…”

mentioning

confidence: 74%

“…They have demonstrated a statistically significant reduction, but of no clinical significance, in median post-chemoradiation ejection fraction (59% to 54%; p50.01). V30 .46% was described [11] as a predictor of development of pericardial effusion for patients receiving chemoradiation of inoperable oesophageal malignancies. In the current study, VMATi reduces V30 by 24% to 31¡4% [1 standard deviation (SD)] and V40 by 10% to 16¡4% (1 SD) when compared with the clinical plan.…”

Section: Volumetric Modulated Arc Therapy For Oesophageal Malignanciesmentioning

confidence: 99%

Volumetric modulated arc therapy planning for distal oesophageal malignancies

Hawkins

Bedford²,

Warrington³

et al. 2012

BJR

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Objectives: Volumetric modulated arc therapy (VMAT) is a novel form of intensitymodulated radiation therapy that allows the radiation dose to be delivered in a single gantry rotation using conformal or modulated fields. The capability of VMAT to reduce heart and cord dose, while maintaining lung receiving 20 Gy ,20%, was evaluated for chemoradiation for oesophageal cancer. Methods: An optimised forward-planned four-field arrangement was compared with inverse-planned coplanar VMAT arcs with 35 control points for 10 patients with lower gastro-oesophageal tumours prescribed 54 Gy in 30 fractions. Conformal (cARC) and intensity-modulated (VMATi) arcs were considered. Plans were assessed and compared using the planning target volume (PTV) irradiated to 95% of the prescription dose (V95), volumes of lung irradiated to 20 Gy (V20), heart irradiated to 30 Gy (V30), spinal cord maximum dose and van't Riet conformation number (CN). The monitor units per fraction and delivery time were recorded for a single representative plan. Results: VMATi provided a significant reduction in the heart V30 (31% vs 55%; p50.02) with better CN (0.72 vs 0.65; p50.01) than the conformal plan. The treatment delivery was 1 min 28 s for VMAT compared with 3 min 15 s. Conclusion: For similar PTV coverage, VMATi delivers a lower dose to organs at risk than conformal plans in a shorter time, and this has warranted clinical implementation.

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“…Wei et al [16] evaluated the incidence of PCE in inoperable oesophageal cancer treated with concurrent chemotherapy and radiotherapy. The crude rate of PCE was 27.7% (28 of 101 patients).…”

Section: Discussionmentioning

confidence: 99%

Stereotactic body radiotherapy for cardiac and paracardiac metastases: University of Florence experience

et al. 2013

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Purpose. This study sought to evaluate acute toxicity and local control in patients who underwent extracranial stereotactic body radiation therapy (SBRT) for paracardiac and cardiac metastatic lesions, defined as such when located at a maximum distance of 1 cm from the heart or inside its parenchyma. Materials and methods. Between January 2009 and May 2011, 16 patients with paracardiac and cardiac lesions were treated with SBRT. For dose specification, in 15 of 16 patients, the prescription dosage was 36 Gy in three fractions (70% isodose). In one patient, the target lesion was inside the heart, and the prescription dosage was 30 Gy in three fractions (70% isodose). Results. Regarding response to stereotactic radiotherapy, we recorded one (6%) complete response (CR), six (37%) partial responses (PR), five (32%) stable disease (SD) and four (25%) local failures. Median interval to local failure was 5.2 (range, 3-12) months. The cause of death was distant progression of disease in all four patients. Compliance to treatment was excellent; no patient developed cardiological symptoms or electrocardiographic abnormalities, even months after SBRT. Conclusions. Results of our retrospective study indicate that SBRT represents a safe and effective treatment option for patients with cardiac and paracardiac metastases. Keywords

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Risk Factors for Pericardial Effusion in Inoperable Esophageal Cancer Patients Treated With Definitive Chemoradiation Therapy

Cited by 162 publications

References 28 publications

Predictive factors for pericardial effusion identified by heart dose–volume histogram analysis in oesophageal cancer patients treated with chemoradiotherapy

Predictive factors for pericardial effusion identified by heart dose–volume histogram analysis in oesophageal cancer patients treated with chemoradiotherapy

Volumetric modulated arc therapy planning for distal oesophageal malignancies

Stereotactic body radiotherapy for cardiac and paracardiac metastases: University of Florence experience

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