High-dose preoperative chemoradiotherapy in esophageal cancer patients does not increase postoperative pulmonary complications: Correlation with dose–volume histogram parameters

2010 ◽  
Vol 97 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Meysan Hurmuzlu ◽  
Kjell Øvrebø ◽  
Tore Wentzel-Larsen ◽  
Ludvig Paul Muren ◽  
Asgaut Viste ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Preoperative Chemoradiotherapy ◽  
Pulmonary Complications ◽  
High Dose ◽  
Dose Volume Histogram ◽  
Postoperative Pulmonary Complications ◽  
Dose Volume

Randomized Controlled Study to Evaluate the Efficacy of a Preoperative Respiratory Rehabilitation Program to Prevent Postoperative Pulmonary Complications after Esophagectomy

2015 ◽  
Vol 32 (5) ◽  
pp. 331-337 ◽  
Author(s):  
Ippei Yamana ◽  
Shinsuke Takeno ◽  
Tatsuya Hashimoto ◽  
Kenji Maki ◽  
Ryosuke Shibata ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Rehabilitation Program ◽  
Pulmonary Complications ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Postoperative Pulmonary Complications ◽  
Postoperative Rehabilitation ◽  
Randomized Controlled ◽  
Respiratory Rehabilitation

Background/Aims: Patients with postoperative pulmonary complications after esophagectomy often have increased mortality. The purpose of the study was to examine the efficacy of preventing postoperative pulmonary complications by an intensive preoperative respiratory rehabilitation (PR) program for esophageal cancer patients. Methods: This study was a prospective randomized controlled study. Thirty patients in the PR group and 30 patients in the no preoperative respiratory rehabilitation (NPR) group were included. The PR group received preoperative rehabilitation for more than 7 days, while the NPR group did not receive any preoperative rehabilitation. All patients underwent postoperative rehabilitation from the first postoperative day. The postoperative pulmonary complications were evaluated using the Clavien-Dindo classification (CDC) and the Utrecht Pneumonia Scoring System (UPSS). Results: The CDC grade in the PR group was significantly lower than that in the NPR group (p = 0.014). The UPSS score in the PR group was significantly lower than that in the NPR group at postoperative day 1 (p = 0.031). In the multivariate analysis, NPR was an independent risk factor for postoperative pulmonary complications greater than CDC grade II (OR: 3.99, 95% CI: 1.28-12.4, p = 0.017). Conclusions: This study showed that the intensive PR program was capable of reducing the postoperative pulmonary complications in esophageal cancer patients.

scholarly journals Biological dosiomic features for the prediction of radiation pneumonitis in esophageal cancer patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Chanon Puttanawarut ◽  
Nat Sirirutbunkajorn ◽  
Suphalak Khachonkham ◽  
Poompis Pattaranutaporn ◽  
Yodchanan Wongsawat
Keyword(s):  
Esophageal Cancer ◽  
Radiation Therapy ◽  
Predictive Model ◽  
Cancer Patients ◽  
Operating Characteristic ◽  
Radiation Pneumonitis ◽  
Dose Volume Histogram ◽  
L1 Norm ◽  
Receiver Operating Characteristic Curves ◽  
Dose Volume

Abstract Objective The purpose of this study was to develop a model using dose volume histogram (DVH) and dosiomic features to predict the risk of radiation pneumonitis (RP) in the treatment of esophageal cancer with radiation therapy and to compare the performance of DVH and dosiomic features after adjustment for the effect of fractionation by correcting the dose to the equivalent dose in 2 Gy (EQD2). Materials and methods DVH features and dosiomic features were extracted from the 3D dose distribution of 101 esophageal cancer patients. The features were extracted with and without correction to EQD2. A predictive model was trained to predict RP grade ≥ 1 by logistic regression with L1 norm regularization. The models were then evaluated by the areas under the receiver operating characteristic curves (AUCs). Result The AUCs of both DVH-based models with and without correction of the dose to EQD2 were 0.66 and 0.66, respectively. Both dosiomic-based models with correction of the dose to EQD2 (AUC = 0.70) and without correction of the dose to EQD2 (AUC = 0.71) showed significant improvement in performance when compared to both DVH-based models. There were no significant differences in the performance of the model by correcting the dose to EQD2. Conclusion Dosiomic features can improve the performance of the predictive model for RP compared with that obtained with the DVH-based model.

Effect of technologic advancements in radiotherapy on postoperative pulmonary complications after neoadjuvant chemoradiation in esophageal cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 110-110
Author(s):  
Bevan H. Myles ◽  
Caimiao Wei ◽  
Ritsuko Komaki ◽  
Ara A. Vaporciyan ◽  
Reza J. Mehran ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Pulmonary Complication ◽  
Neoadjuvant Chemoradiation ◽  
Pulmonary Complications ◽  
Complication Rates ◽  
Postoperative Pulmonary Complications ◽  
Radiation Technology ◽  
3D Crt

110 Background: Although 3D conformal radiation therapy (3D-CRT) is currently the de facto standard for the treatment of esophageal cancers, technologies such as Intensity Modulated Radiation Therapy (IMRT) or Proton Beam Therapy (PBT) are increasingly being used, but the evidence for the clinical benefits of these technologies are lacking. We hypothesized that radiation technology influences perioperative complications in esophageal cancer patients treated with neoadjuvant chemoradiation. Methods: We evaluated 423 patients (3D-CRT (n=208, 1998-2008), IMRT (n=165, 2004-2011), and PBT (n=50, 2006-2011)) treated with surgical resection after chemoradiation from 1998-2011 at M. D. Anderson Cancer Center. Postoperative complications (Pulmonary, GI, cardiac, wound healing) were recorded up to 30 days postoperatively. Kruskal-Wallis tests and Chi-square or Fisher’s exact tests assessed associations between continuous and categorical variables and the radiation technology, respectively. Logistic regression model tested the association between treatment technologies and complications adjusting for other significant patient characteristics. Results: While radiation modality was not significantly associated with postoperative GI (leak, ileus, fistula), cardiac (MI, AF, CHF), and wound complications, there was a significant reduction in postoperative pulmonary complications (ARDS, pleural effusion, respiratory insufficiency, pneumonia) for IMRT compared to 3D-CRT (OR 0.46, 95%CI 0.25, 0.83) and PBT compared to 3D-CRT (OR 0.26, 95%CI 0.09, 0.70), but not when IMRT was compared to PBT (OR 1.74, 95%CI 0.66, 4.61) after adjusting for preRT DLCO level. The median length of hospital stay was also significantly different between treatment modalities (12, 10, and 8 days for 3D-CRT, IMRT, and PBT, respectively, p<0.0001). There was no significant association between treatment year with pulmonary complication rates. Conclusions: Radiation technologies such as IMRT and PBT reduced postoperative pulmonary complication rates compared to 3D-CRT in esophageal cancer patients. This result needs to be confirmed in larger prospective studies.

Sign in / Sign up

Export Citation Format

Share Document