The relationship between the dose-volume indexes and acute toxicity of intrathoracic stomach in esophageal cancer patients receiving radiotherapy after esophagectomy

Q4 Medicine 中华放射医学与防护杂志 Pub Date : 2020-02-25 DOI:10.3760/CMA.J.ISSN.0254-5098.2020.02.006

Chunyan Song, Shuchai Zhu, W. Shen, Jing-wei Su, Sina Gao, Yan Zhao, Jinrui Xu, Shu-guang Li

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引用次数: 2

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 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. Key words: Esophageal carcinoma; Operation; Intrathoracic stomach irradiation injury; Dose-volume indexes

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食管癌食管切除术后放疗患者剂量-体积指标与胸内胃急性毒性的关系

目的探讨食管癌患者食管切除术后放疗的剂量-容量指标与胸内胃急性毒性的关系。方法对104例术后放疗合并根治性食管切除术患者进行回顾性分析。从治疗计划系统中采集胸内胃剂量-体积指标。采用ROC曲线和logistic回归分析胸内胃急性毒性与临床参数、剂量-体积指标的关系。结果2级及以上急性毒性29例(27.88%)。ROC曲线分析显示，Dmax、Dmean、L5-L45、v5 - v50等剂量-体积指标与2级及以上急性毒性的发生相关。单因素分析显示，部位、Dmax、Dmean、L5- l45、V5-V50与2级及以上急性毒性发生率显著相关(L5≥14.00 cm为14.00 cm, V35≥44.00%为14.08%，V35≥44.00%为57.58%，χ2=7.263, P<0.05)，差异有统计学意义(χ2=4.473, P<0.05)。纵隔后胃组2级及以上急性毒性发生率显著高于其他两组(χ2=12.881, P<0.05)。结论剂量-体积指数可作为预测胸内胃急性毒性的指标。食管癌患者术后需要放疗时，建议慎重选择纵隔后胃。关键词:食管癌;操作;胸内胃辐照损伤;Dose-volume索引

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