Mapping of failures after radiochemotherapy in patients with non-metastatic esophageal cancer: A posteriori analysis of the dose distribution in the sites of loco-regional relapse. Issue 2 (August 2015)

• Record Type: Journal Article
• Authors: Bednarek, Coraline; Crehange, Gilles; Quivrin, Magali; Cueff, Adèle; Vulquin, Noémie; Chevalier, Cédric; Cerda, Thomas; Petegnief, Yolande; Mazoyer, Frédéric; Maingon, Philippe; Bosset, Jean François; Servagi Vernat, Stéphanie
• Is Part Of: Radiotherapy and oncology. Volume 116:Issue 2(2015:Aug.)
• Page Start: 252
• Page End: 256
• Publication Date: 2015-08
• Subjects: Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2015.07.019
• Languages: English
• ISSNs: 0167-8140

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st005">Abstract</title> <sec> <title id="st010">Background and purpose</title> <p id="sp0005">We aimed to evaluate the patterns of loco-regional failure (LRF) after exclusive chemoradiotherapy (eCRT) for esophageal cancer with respect to planned dose and/or the incidental (unplanned) dose outside target volumes.</p> </sec> <sec> <title id="st015">Materials and methods</title> <p id="sp0010">Co-image registration of CT or <sup>18</sup>F-FDG PET-CT at the time of failure (tf) and at the time of CRT (t0) was performed in 34 patients with LRF. Dosimetric parameters with regard to local failure (LF), nodal failure (NF) and involved nodal stations (NS) were derived.</p> </sec> <sec> <title id="st020">Results</title> <p id="sp0015">Twenty-two patients (64.7%) had LF, the majority of which (95.5%) were located at the epicenter of the GTV of the primary tumor. The mean doses recalculated to the NS at tf were more likely to be lower than the planned dose delivered to the PTV at t0: <italic>D</italic><sub>mean</sub> = 33.9 ± 20.8 Gy vs 52.2 ± 8.5 Gy (<italic>p</italic> = 0.0009), <italic>D</italic><sub>95%</sub> = 27.5 ± 21 Gy vs 46.1 ± 4.8 Gy (<italic>p</italic> = 0.004). Among the 12 patients with NF outside the elective nodal irradiation (ENI) volume, <italic>D</italic><sub>mean</sub> of NS outside the ENI was significantly lower (19.4 ± 21.4 Gy) than the <italic>D</italic><sub>mean</sub> of NS with failure within the ENI (45.1 ± 6.1 Gy, <italic>p</italic> = 0.01).</p> </sec> <sec> <title id="st025">Conclusion</title> <p id="sp0020">Loco-regional failure after exclusive chemoradiotherapy for esophageal cancer may be due to an inadequately low dose.</p> </sec> </abstract>