Cardiac function after chemoradiation for esophageal cancer: comparison of heart dose-volume histogram parameters to multiple gated acquisition scan changes

2005 ◽  
Vol 18 (6) ◽  
pp. 400-405 ◽  
Author(s):  
P. Tripp ◽  
H. K. Malhotra ◽  
M. Javle ◽  
A. Shaukat ◽  
R. Russo ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cardiac Function ◽  
Dose Volume Histogram ◽  
Heart Dose ◽  
Dose Volume ◽  
Gated Acquisition

scholarly journals Analysis of cardiac toxicity after definitive chemoradiotherapy for esophageal cancer using a biological dose–volume histogram

2020 ◽  
Vol 61 (2) ◽  
pp. 298-306
Author(s):  
Yuki Takeuchi ◽  
Yuji Murakami ◽  
Tsubasa Kameoka ◽  
Masanori Ochi ◽  
Nobuki Imano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Cardiac Toxicity ◽  
Dose Volume Histogram ◽  
Definitive Chemoradiotherapy ◽  
Heart Dose ◽  
Dose Volume ◽  
The Mean ◽  
Mean Heart Dose ◽  
The Relationship

Abstract This study aimed to evaluate the relationship between cardiac toxicity after definitive chemoradiotherapy (CRT) for esophageal cancer and the dose–volume histogram (DVH) of organs at risk (OARs) [using biological effective dose (BED)]. We analyzed the data of 83 patients with esophageal cancer treated using definitive CRT between 2001 and 2016. Furthermore, we evaluated pericardial effusion (PE) as a measure of cardiac toxicity. The median total irradiation dose was 60 (50.4–71) Gy. Symptomatic PE was observed in 12 (14%) patients. The heart and pericardium V5–V100-BED were significantly higher in patients with symptomatic PE than in those without symptomatic PE (heart: V5–V95-BED, P < 0.001; V100-BED, P = 0.0053, and pericardium: V5–V40-BED, V55–V95-BED, P < 0.001; V45–50-BED, V100-BED, P < 0.05, respectively). Receiver operating characteristic curve analysis showed that the dose–volume parameter of the pericardium and the heart that was most strongly associated with an adverse cardiac event was V80-BED, and the mean dose and the cut-off value were 27.38% and 61.7 Gy-BED, respectively. Multivariate analysis showed that the pericardium V80-BED and the mean heart dose-BED were risk factors for symptomatic PE (P < 0.001, respectively). We revealed the relationship between the irradiated dose of the OARs and symptomatic PE using a BED-based dose–volume histogram. Pericardium V80-BED and mean heart dose-BED were the most relevant risk factors for symptomatic PE.

Correlation of heart dose with lymphopenia in esophageal cancer patients treated with chemoradiation.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 346-346
Author(s):  
Amber Post ◽  
Stephen R. Bowen ◽  
Bao-Ngoc Nguyen ◽  
William Logan ◽  
Jing Zeng ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Blood Pool ◽  
Hematologic Toxicity ◽  
Characteristic Analysis ◽  
Heart Dose ◽  
Dose Volume ◽  
Vertebral Bodies ◽  
Grade 3 ◽  
The Cost

346 Background: Lymphopenia has been associated with survival and disease progression in esophageal cancer patients treated with chemoradiation (cRT). We previously published on our posterior-only proton therapy approach that maximally spares the heart and lungs, but at the cost of increased dose to the bone marrow in the vertebral bodies (VBs). We assessed hematologic toxicity in proton (PT) and IMRT treated patients and studied dosimetric parameters associated with hematologic toxicity. Methods: 35 patients treated with PT and 46 patients treated with IMRT for esophageal cancer between 2011-2018 were analyzed. Most patients were treated concurrently with carboplatin/paclitaxel to a median dose of 50.4 Gy. Lymphocyte, neutrophil and total leukocyte values while under treatment were recorded and graded per the CTCAE v4.03 toxicity scale, and the neutrophil-to-lymphocyte ratio (NLR) was computed. Mean dose and volumes (cc) receiving 5-50 Gy were calculated for the heart and VBs. A receiver-operator characteristic analysis was performed for univariate correlation between incidence of grade ≥3 hematotoxicity and dose-volume parameters. Results: Median follow-up was 36.1 months for all patients and the overall survival at 3 years was 57.5%. The rates of grade 3 or 4 hematologic toxicity in the PT group were 37.1% (leukopenia), 22.9% (neutropenia), and 80.0% (lymphopenia) versus 41.3%, 15.2% and 87.2%, respectively, for IMRT patients. There was a significant correlation between grade 4 lymphopenia and the heart V5, V10 and V20, but no significant correlation between VB doses with any hematotoxicity. Median NLR values and heart dose were higher in the IMRT group (9.17 vs 3.86 with PT, p = 0.0048; 10.5 vs 23.5Gy, p< 0.0001, respectively). There was a correlation between survival and NLR with a hazard ratio of 1.025 (CI 1.006 - 1.044). Conclusions: Low doses to the heart mediate severe lymphopenia in esophageal cancer patients treated with cRT. These data confirm the safety of the posterior-only proton approach without concern for increased hematologic toxicity despite higher vertebral body doses compared to IMRT. They also suggest that the blood pool is more important as a source of severe lymphopenia.

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.

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