| Song Chunyang,Zhu Shuchai,Shen Wenbin,et al.The relationship between the dose-volume indexes and acute toxicity of intrathoracic stomach in esophageal cancer patients receiving radiotherapy after esophagectomy[J].Chinese Journal of Radiological Medicine and Protection,2020,40(2):106-111 |
| The relationship between the dose-volume indexes and acute toxicity of intrathoracic stomach in esophageal cancer patients receiving radiotherapy after esophagectomy |
| Received:August 27, 2019 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.02.006 |
| KeyWords:Esophageal carcinoma Operation Intrathoracic stomach irradiation injury Dose-volume indexes |
| FundProject:河北省医学科学研究重点课题计划（20170758） |
| Author Name | Affiliation | E-mail | | Song Chunyang | Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Zhu Shuchai | Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | sczhu1965@163.com | | Shen Wenbin | Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Su Jingwei | Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Gao Sina | Department of Nephrology, The Third hospital of Shijiazhuang, Shijiazhuang 050011, China | | | Zhao Yan | Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Xu Jinrui | Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Li Shuguang | Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | |
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| 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-V50 were 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<0.05). The multivariate analysis showed that location, L5 and V35 were independent factors for incidence of grade 2 or above acute toxicity. The ROC curve analysis showed that cut-off values of L5 and V35 were 14.00 cm and 44.00%, respectively. And the rates of Grade 2 or above acute toxicity were 20.00% for L5>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. |
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