Radiation dose to the lymph drainage area in esophageal cancer with involved-field irradiation
- Authors:
- Wenbin Shen
- Hongmei Gao
- Shuchai Zhu
- Youmei Li
- Juan Li
- Zhikun Liu
- Jinwei Su
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Affiliations: Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China, Department of Radiation Oncology, The First Hospital of Shijiazhuang, Shijiazhuang, Hebei 050011, P.R. China
- Published online on: November 23, 2015 https://doi.org/10.3892/ol.2015.3952
-
Pages:
849-855
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Abstract
The aim of this study was to quantify the radiation dose to the corresponding lymph drainage area in esophageal cancer using three-dimensional conformal radiation therapy (3D-CRT) with involved-field irradiation (IFI) and to analyze associated factors. A retrospective analysis of 81 patients with esophageal cancer was conducted. according to the location of the lesions, the lymph drainage area was delineated and the dosimetric parameters were calculated. The 1‑, 3‑, 5‑ and 8‑year survival rates of the patients were 67.90, 33.33, 20.99 and 11.11%, respectively. Based on the dose‑volume histogram in the treatment plan, we calculated the volume percentage of the planning target volume including clinically positive lymph nodes (PTV‑N) receiving radiation doses of 30, 35, 40, 45 and 50 Gy (VPTV‑n30-50). The median values of VPTV‑n30‑50 were 73, 70, 67, 64 and 58%, respectively. The prescribed dose size exhibited no correlation with VPTV‑n30‑35, but did exhibit a significant correlation with VPTV‑n40‑50; the radiation field was not correlated with VPTV‑n30‑45, but exhibited a significant correlation with VPTV‑n50; the length of the lesion on esophageal barium meal X‑ray and the PTV were significantly correlated with VPTV‑n30‑50. The analysis of variance revealed that the VPTV‑nX value in the upper thoracic segment was higher compared with that in the middle and lower thoracic segments; VPTV‑n30‑35 values differed significantly according to the different locations of the lesions, whereas VPTV‑n40‑50 values exhibited no significant differences. The value of VPTV‑nX exerted no significant effect on long‑term patient survival. Therefore, the corresponding lymph drainage area of esophageal cancer is subjected to a certain radiation dose when patients undergo 3D‑CRT with IFI, which may play a role in the prevention of regional nodal metastasis. However, this hypothesis requires confirmation by further clinical studies.
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