Relationship between sternum protection and bone marrow suppression in postoperative radiotherapy for esophageal carcinoma
10.3760/cma.j.issn.1006-9801.2015.07.008
- VernacularTitle:食管癌术后放疗胸骨保护与骨髓抑制的关系
- Author:
Fei GAO
;
Lin JIA
;
Xiaobo DU
;
Yu ZHAO
;
Jianjun HAN
;
Dong JIA
;
Yan CHEN
;
Yanmei MIN
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasms;
Surgical procedures,operative;
Sternum protection;
Radiotherapy,computer-assisted;
Bone marrow suppression
- From:
Cancer Research and Clinic
2015;(7):461-464
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the relationship between sternum protection and bone marrow suppression in postoperative radiotherapy for esophageal carcinoma. Methods Total of 98 postoperative patients with thoracic esophageal carcinoma were randomly divided into experimental group (52 cases) and control group (46 cases). All patients were given intensity-modulated radiotherapy (IMRT), with the dose of 50-50.4 Gy. The patients in experimental group were irradiated by 6 fields (4-fields in front, 2-fields behind) which were crossed to avoid direct exposure to the sternum. The patients in control group were irradiated by 5 fields (3-fields in front, 2-fields behind) with front-middle of the field passing through the sternum. Concurrently all patients received 2 cycles of cisplatin chemotherapy. Results Dmean, V20 and V30 of the sternum in the experimental group were (20.21 ±3.60) Gy, (40.78 ±7.19) % and (33.78 ±9.44) %, which were lower than those in the control group [(30.91±5.21) Gy, (81.01±4.81) %, (51.60±6.84) %], respectively (P<0.05). However, the volume and dose distribution of lung, spinal cord and heart were similar between the two groups (P> 0.05). Both the incidence rates of bone marrow suppression at 14th day and 35th day after radiotherapy were significantly higher in the control group (52.2%, 73.9%) than those in the experimental group (28.8 %, 50.0 %) (P< 0.05), and the incidence rate of bone marrow suppression at 7th day after radiotherapy was similar between the two groups. Conclusion Protecting and sketching for sternum in postoperative radiotherapy for esophageal carcinoma can reduce the incidence of bone marrow suppression effectively, which would not increase the radiation dose in the lung, heart and spinal cord.
