The relationship between the dose-volume indexes and acute toxicity of intrathoracic stomach in esophageal cancer patients receiving radiotherapy after esophagectomy
10.3760/cma.j.issn.0254-5098.2020.02.006
- VernacularTitle: 食管癌根治切除术后辅助调强放疗胸腔胃照射剂量与急性放射性胸腔胃炎的关系
- Author:
Chunyang SONG
1
;
Shuchai ZHU
1
;
Wenbin SHEN
1
;
Jingwei SU
1
;
Sina GAO
2
;
Yan ZHAO
1
;
Jinrui XU
1
;
Shuguang LI
1
Author Information
1. Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
2. Department of Nephrology, The Third hospital of Shijiazhuang, Shijiazhuang 050011, China
- Publication Type:Journal Article
- Keywords:
Esophageal carcinoma;
Operation;
Intrathoracic stomach irradiation injury;
Dose-volume indexes
- From:
Chinese Journal of Radiological Medicine and Protection
2020;40(2):106-111
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the relationship between the dose-volume indexes and acute toxicity of intrathoracic stomach in esophageal cancer patients receiving radiotherapy after esophagectomy.
Methods:A total of 104 patients treated with postoperative radiotherapy followed by radical esophagectomy were enrolled. The dose-volume indexes of intrathoracic stomach were collected from treatment planning system. The ROC curve and logistic regression were performed to analyze the relationship between acute toxicity of intrathoracic stomach and clinical parameters, dose-volume indexes.
Results:A total of 29 patients (27.88 %) suffered from grade 2 or above acute toxicity. The ROC curve analysis showed that the dose-volume indexes including Dmax, Dmean, L5-L45 and V5-V50were associated with occurrence of grade 2 or above acute toxicity. The univariate analysis showed that location, Dmax, Dmean, L5-L45 and V5-V50 were significantly correlated with the incidence of grade 2 or above acute toxicity (P<0.05). The multivariate analysis showed that location, L5 and V35 were independent factors for incidence of grade 2 or above acute toxicity. The ROC curve analysis showed that cut-off values of L5 and V35 were 14.00 cm and 44.00%, respectively. And the rates of Grade 2 or above acute toxicity were 20.00% for L5>14.00 cm and 38.64% for L5≥14.00 cm (χ2=4.473, P<0.05), 14.08% for V35<44.00% and 57.58% for V35≥44.00% (χ2=7.263, P<0.05), respectively. The incidence of grade 2 or above acute toxicity was significantly higher in post-mediastinum stomach group than the other two groups (χ2=12.881, P<0.05).
Conclusions:Dose-volume index may be indicator to predict acute toxicity of intrathoracic stomach. It is recommended that post-mediastinum stomach should be chosen carefully if esophageal cancer patients require postoperative radiotherapy.
