Radiation therapy for gastric wall metastasis from esophageal carcinoma

125 Background: Treatment for locally advanced esophageal carcinoma is radiation and chemotherapy, with or without surgery. Radiation has traditionally been delivered with 3D conformal radiation therapy (3D CRT). This study evaluates late toxicity in patients treated with IMRT as well as early outcomes and acute toxicity. Methods: This is a retrospective review of 32 patients with esophageal carcinoma treated with IMRT at Mayo Clinic Florida from 2008 -2012. Pathology includes squamous cell and adenocarcinomas. Tumor sites include middle and lower thoracic and GE junction. Clinical stages are TX-T3, N0-3, M0-1. All patients received at least one cycle of concurrent chemotherapy. IMRT dose was 50.4 Gy in 28 fractions prescribed to a target volume including the tumor and regional lymphatics. IMRT plans utilized coplaner beams in a 7-9 beam arrangement or volumetric modulated arc therapy. Results: Median follow-up is 8.9 months (range 2.4-23.0) for all patients and 13.1 months (range 2.8-23.0 months) in surviving patients. Median patient age is 69 (range 46-87). Trimodality treatment was completed in 20 patients (62.5%). Surgery was either an open or minimally invasive esophagogastrectomy. The incidence of grade 3 or greater late toxicity at 1 year was 48% in surgery patients and 26% in non-surgery patients. The most common grade 3 or higher toxicity was esophageal strictures in 25%. The incidence of any grade 3 or greater acute toxicity was 65% in the surgery patients and 75% in the non-surgery patients. Overall survival (OS) for all patients at 18 months is 57% (CI 37-86%) and progression-free survival (PFS) is 60% (36-99%). OS and PFS for trimodality therapy at 12 months is 83% (66-100%) and 81% (63-100%) respectively and for bimodality therapy is 34% (12-93%) and 70% (33-100%) respectively. Conclusions: Increased late toxicity occurs in surgery patients, and increased acute toxicity in non-surgery patients. Lower survival in non-surgery patients may be due to early progression, morbidities which preclude surgery or improved survival with surgery. Overall, IMRT is a feasible treatment modality, which may be equally efficacious to 3D CRT for the treatment of esophageal carcinoma.

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Radiation Therapy of Secondary Nodal Metastases in the Neck and Mediastinum after Resection of Esophageal Carcinoma

Acta Radiologica Oncology Radiation Physics Biology ◽

10.3109/02841867909128204 ◽

1979 ◽

Vol 18 (3) ◽

pp. 171-176 ◽

Cited By ~ 1

Author(s):

Toshihiko Inoue ◽

S. Hori ◽

Takehiro Inoue ◽

K. Taniguchi ◽

T. Kabuto ◽

...

Keyword(s):

Radiation Therapy ◽

Esophageal Carcinoma ◽

Nodal Metastases

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Comparison of Temporary and Permanent Stent Placement with Concurrent Radiation Therapy in Patients with Esophageal Carcinoma

Journal of Vascular and Interventional Radiology ◽

10.1097/01.rvi.0000142585.90055.74 ◽

2005 ◽

Vol 16 (1) ◽

pp. 67-74 ◽

Cited By ~ 55

Author(s):

Ji Hoon Shin ◽

Ho-Young Song ◽

Jong Hoon Kim ◽

Sung-Bae Kim ◽

Gin Hyug Lee ◽

...

Keyword(s):

Radiation Therapy ◽

Esophageal Carcinoma ◽

Stent Placement

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Dosimetric Study of Coplanar and Non-Coplanar Intensity-Modulated Radiation Therapy Planning for Esophageal Carcinoma

International Journal of Medical Physics Clinical Engineering and Radiation Oncology ◽

10.4236/ijmpcero.2013.24018 ◽

2013 ◽

Vol 02 (04) ◽

pp. 133-138

Author(s):

Ying Li ◽

Bing Liu ◽

Fushan Zhai ◽

Yongfeng Yang ◽

Ming Liu ◽

...

Keyword(s):

Radiation Therapy ◽

Esophageal Carcinoma ◽

Intensity Modulated Radiation Therapy ◽

Therapy Planning ◽

Intensity Modulated ◽

Radiation Therapy Planning ◽

Dosimetric Study

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Comparison of Simultaneous Integrated Boost and Late-course Boost Intensity-modulated Radiation Therapy in the Treatment of Esophageal Carcinoma

10.21203/rs.3.rs-835617/v1 ◽

2021 ◽

Author(s):

Yu Xiao ◽

Guobo Du ◽

Jianping Hu ◽

Tingting Wu ◽

Xue Meng ◽

...

Keyword(s):

Overall Survival ◽

Radiation Therapy ◽

Esophageal Carcinoma ◽

Local Control ◽

Intensity Modulated Radiation Therapy ◽

Simultaneous Integrated Boost ◽

Entire Group ◽

Target Area ◽

Intensity Modulated ◽

Integrated Boost

Abstract This paper aimed to analyze and compare the outcomes of esophageal carcinoma treated with simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and late-course boost intensity-modulated radiation therapy (LCB-IMRT). The retrospective study was designed to analyze the clinical data of 274 esophageal cancer patients who received radical radiotherapy in the Oncology Department of our hospital, from January 2014 to December 2017. Propensity score matching analysis was used to balance the variable differences in the two groups. Survival, toxicities, and target dose were observed and compared between the two groups. Statistical analysis was performed using SPSS 24.0 software. P<0.05 judged to be statistically significant. 200 patients were finally included after propensity scores matching , The 1-, 3-, and 5-year overall survival and local control rates of the entire group were 80.5% vs. 67.6%, 38.2% vs. 31.3%，and 22.2% vs. 20.4%, respectively. The 1-, 3-, and 5-year overall survival rates of the SIB-IMRT and LCB-IMRT group were 85.0% vs. 76.0%, 41.8% vs. 34.5%, and 25.5% vs. 21.3%, respectively (P＞0.05). The 1-, 3-, and 5- year local control rates of the SIB-IMRT and LCB-IMRT group were 77.3% vs. 58.0%, 31.4% vs. 30.1%, and 20.0% vs. 20.7%, respectively (P＞0.05). The recent total effective rates of the SIB-IMRT and LCB-IMRT group were 96.0% vs. 92.0% (P＞0.05). There were statistically significant differences in the incidence of ≥2 grade acute radiation esophagitis and pneumonia between the two groups (P＜0.05). The does of lung V5, lung V10, lung Dmean, and spinal cord Dmax in the SIB-IMRT group were significantly lower than those in LCB-IMRT group (P＜0.05). Patients age, tumor location, tumor length, gross tumor target volume, N stage were independent prognostic factors of overall survival and local control. Compared with the LCB-IMRT group, the survival prognosis of the SIB-IMRT group has benefit trend, patients in the SIB-IMRT group received less radiation dose to the normal organs around the target area, and the toxicities effects of radiotherapy were lighter, which is more conducive to the protection of normal tissues around the target area.

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