Dosimetric advantages for cardiac substructures in radiotherapy of esophageal cancer in deep-inspiration breath hold.
CROSS protocol
Cardiac toxicity
Chemoradiotherapy
Neoadjuvant
Pulmonary toxicity
Journal
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
ISSN: 1439-099X
Titre abrégé: Strahlenther Onkol
Pays: Germany
ID NLM: 8603469
Informations de publication
Date de publication:
05 Feb 2024
05 Feb 2024
Historique:
received:
23
05
2023
accepted:
03
01
2024
medline:
5
2
2024
pubmed:
5
2
2024
entrez:
5
2
2024
Statut:
aheadofprint
Résumé
Radiotherapy is one of the main treatment options for patients with esophageal cancer; however, it has been linked with an increased risk of cardiac toxicities. In the current study, we evaluated the effect of planning the radiation in deep-inspiration breath hold (DIBH) on the dose sparing of cardiac substructures and lung. In this study, we analyzed 30 radiation therapy plans from 15 patients diagnosed with esophageal cancer planned for neoadjuvant radiotherapy. Radiation plans were generated for 41.4 Gy and delivered in 1.8 Gy per fraction for free-breathing (FB) and DIBH techniques. We then conducted a comparative dosimetric analysis, evaluating target volume coverage, the impact on cardiac substructures, and lung doses across the two planning techniques for each patient. There was no significant disparity in target volume dose coverage between DIBH and FB plans. However, the D Radiotherapy in DIBH could provide a method to reduce the radiation dose to the left ventricle and coronaries, which could reduce the cardiac toxicity of the modality.
Sections du résumé
BACKGROUND
BACKGROUND
Radiotherapy is one of the main treatment options for patients with esophageal cancer; however, it has been linked with an increased risk of cardiac toxicities. In the current study, we evaluated the effect of planning the radiation in deep-inspiration breath hold (DIBH) on the dose sparing of cardiac substructures and lung.
MATERIALS AND METHODS
METHODS
In this study, we analyzed 30 radiation therapy plans from 15 patients diagnosed with esophageal cancer planned for neoadjuvant radiotherapy. Radiation plans were generated for 41.4 Gy and delivered in 1.8 Gy per fraction for free-breathing (FB) and DIBH techniques. We then conducted a comparative dosimetric analysis, evaluating target volume coverage, the impact on cardiac substructures, and lung doses across the two planning techniques for each patient.
RESULTS
RESULTS
There was no significant disparity in target volume dose coverage between DIBH and FB plans. However, the D
CONCLUSION
CONCLUSIONS
Radiotherapy in DIBH could provide a method to reduce the radiation dose to the left ventricle and coronaries, which could reduce the cardiac toxicity of the modality.
Identifiants
pubmed: 38315236
doi: 10.1007/s00066-024-02197-8
pii: 10.1007/s00066-024-02197-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Survival Rates for Esophageal Cancer | Esophageal Cancer Outlook. https://www.cancer.org/cancer/esophagus-cancer/detection-diagnosis-staging/survival-rates.html#references . Accessed 12 Mar 2023
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68(6):394–424
doi: 10.3322/caac.21492
pubmed: 30207593
Lin Y, Wang H, Fang K, Zheng Y, Wu J (2022) International trends in esophageal cancer incidence rates by histological subtype (1990–2012) and prediction of the rates to 2030. Esophagus 19(4):560–568
doi: 10.1007/s10388-022-00927-4
pubmed: 35689719
van Hagen P, Hulshof MCCM, van Lanschot JJB, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BPL, Richel DJ, Nieuwenhuijzen GAP, Hospers GAP, Bonenkamp JJ et al (2012) Preoperative Chemoradiotherapy for Esophageal or Junctional Cancer. N Engl J Med 366(22):2074–2084. https://doi.org/10.1056/NEJMoa1112088
doi: 10.1056/NEJMoa1112088
pubmed: 22646630
Reynolds JV, Preston SR, O’Neill B, Lowery MA, Baeksgaard L, Crosby T, Cunningham M, Cuffe S, Griffiths GO, Roy R et al (2021) Neo-AEGIS (Neoadjuvant trial in Adenocarcinoma of the Esophagus and Esophago-Gastric Junction International Study): Preliminary results of phase III RCT of CROSS versus perioperative chemotherapy (Modified MAGIC or FLOT protocol). (NCT01726452). J Clin Oncol 39(15_suppl):4004. https://doi.org/10.1200/JCO.2021.39.15_suppl.4004
doi: 10.1200/JCO.2021.39.15_suppl.4004
Piroth MD, Baumann R, Budach W, Dunst J, Feyer P, Fietkau R, Haase W, Harms W, Hehr T, Krug D et al (2019) Heart toxicity from breast cancer radiotherapy. Strahlenther Onkol 195(1):1–12. https://doi.org/10.1007/s00066-018-1378-z
doi: 10.1007/s00066-018-1378-z
pubmed: 30310926
Jaworski C, Mariani JA, Wheeler G et al (2013) Cardiac complications of thoracic irradiation. J Am Coll Cardiol 61(23):2319–2328. https://doi.org/10.1016/j.jacc.2013.01.090
doi: 10.1016/j.jacc.2013.01.090
pubmed: 23583253
Gharzai L, Verma V, Denniston KA, Bhirud AR, Bennion NR, Lin C (2016) Radiation therapy and cardiac death in long-term survivors of esophageal cancer: an analysis of the surveillance, epidemiology, and end result database. Bruns H, editor. Plos One 11(7):e158916. https://doi.org/10.1371/journal.pone.0158916
doi: 10.1371/journal.pone.0158916
pubmed: 27428362
pmcid: 4948887
Wang X, Palaskas NL, Yusuf SW, Abe J‑I, Lopez-Mattei J, Banchs J, Gladish GW, Lee P, Liao Z, Deswal A et al (2020) Incidence and onset of severe cardiac events after radiotherapy for esophageal cancer. J Thorac Oncol 15(10):1682–1690
doi: 10.1016/j.jtho.2020.06.014
pubmed: 32599073
pmcid: 9398884
Hayashi Y, Iijima H, Isohashi F, Tsujii Y, Fujinaga T, Nagai K, Yoshii S, Sakatani A, Hiyama S, Shinzaki S et al (2019) The heart’s exposure to radiation increases the risk of cardiac toxicity after chemoradiotherapy for superficial esophageal cancer: A retrospective cohort study. BMC Cancer 19(1):1–7. https://doi.org/10.1186/s12885-019-5421-y
doi: 10.1186/s12885-019-5421-y
Witt JS, Jagodinsky JC, Liu Y, Yadav P, Kuczmarska-Haas A, Yu M, Maloney JD, Ritter MA, Bassetti MF, Baschnagel AM (2019) Cardiac toxicity in operable esophageal cancer patients treated with or without chemoradiation. Am J Clin Oncol 42(8):662
doi: 10.1097/COC.0000000000000573
pubmed: 31313677
pmcid: 6828548
Lin SH, Hobbs BP, Verma V, Tidwell RS, Smith GL, Lei X, Corsini EM, Mok I, Wei X, Yao L et al (2020) Randomized phase IIB trial of proton beam therapy versus intensity-modulated radiation therapy for locally advanced esophageal cancer. J Clin Oncol 38(14):1569
doi: 10.1200/JCO.19.02503
pubmed: 32160096
pmcid: 7213588
Hoeppner J, Lordick F, Brunner T, Glatz T, Bronsert P, Röthling N, Schmoor C, Lorenz D, Ell C, Hopt UT et al (2016) ESOPEC: Prospective randomized controlled multicenter phase III trial comparing perioperative chemotherapy (FLOT protocol) to neoadjuvant chemoradiation (CROSS protocol) in patients with adenocarcinoma of the esophagus (NCT02509286). BMC Cancer 16(1)
Wolf J, Stoller S, Lübke J, Rothe T, Serpa M, Scholber J, Zamboglou C, Gkika E, Baltas D, Juhasz-Böss I et al (2022) Deep inspiration breath-hold radiation therapy in left-sided breast cancer patients: a single-institution retrospective dosimetric analysis of organs at risk doses. Strahlenther Onkol 199(4):379–388. https://doi.org/10.1007/s00066-022-01998-z
doi: 10.1007/s00066-022-01998-z
pubmed: 36074138
pmcid: 10033469
Josipovic M, Aznar MC, Thomsen JB, Scherman J, Damkjaer SMS, Nygård L, Specht L, Pøhl M, Persson GF (2019) Deep inspiration breath hold in locally advanced lung cancer radiotherapy: validation of intrafractional geometric uncertainties in the INHALE trial. Br J Radiol 92(1104)
Yan D, Ning L, Chen Y, Ke S, Huang H, Wang L, Yan S (2022) Analysis of deep inspiration breath-hold technique to improve dosimetric and clinical advantages in postoperative intensity-modulated radiation therapy for thymomas. Quant Imaging Med Surg 12(8):4239–4247
doi: 10.21037/qims-21-1101
pubmed: 35919039
pmcid: 9338384
Lorchel F, Dumas JL, Noë A, Wolf D, Bosset JF, Aletti P (2006) Dosimetric consequences of breath-hold respiration in conformal radiotherapy of esophageal cancer. Phys Med 22(4):119–126
doi: 10.1016/S1120-1797(06)80047-5
Duane F, Aznar MC, Bartlett F, Cutter DJ, Darby SC, Jagsi R, Lorenzen EL, Mcardle O, Mcgale P, Myerson S et al (2017) Cardiac contouring atlas A cardiac contouring atlas for radiotherapy. Radiother Oncol 122:416–422
doi: 10.1016/j.radonc.2017.01.008
pubmed: 28233564
pmcid: 5356506
Cai G, Li C, Li J, Yang J, Li C, Sun L, Li J, Yu J, Meng X (2023) Cardiac substructures dosimetric predictors for cardiac toxicity after definitive radiotherapy in esophageal cancer. Int J Radiat Oncol 115(2):366–381
doi: 10.1016/j.ijrobp.2022.08.013
Burke AM, Yeh C, Kim S, Bergquist P, Krishnan P, Barac A, Srichai MB, Unger K (2020) A prospective study of early radiation associated cardiac toxicity following neoadjuvant chemoradiation for distal esophageal cancer. Front Oncol 10:1169
doi: 10.3389/fonc.2020.01169
pubmed: 32903617
pmcid: 7438722
Carroll RG (2007) Integrated cardiovascular function. In: Elsevier’s Integr Physiol, vol 1, pp 91–98
doi: 10.1016/B978-0-323-04318-2.50015-7
Persson GF, Scherman Rydhög J, Josipovic M, Maraldo MV, Nygård L, Costa J, Berthelsen AK, Specht L, Aznar MC (2016) Deep inspiration breath-hold volumetric modulated arc radiotherapy decreases dose to mediastinal structures in locally advanced lung cancer. Acta Oncol 55(8):1053–1056. https://doi.org/10.3109/0284186X.2016.1142115
doi: 10.3109/0284186X.2016.1142115
pubmed: 26935017
Darby SC, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Brønnum D, Correa C, Cutter D, Gagliardi G, Gigante B et al (2013) Risk of is che mic heart disease in women after radiotherapy for breast cancer (abstract from the clinical trial service unit mark; the department of medical Epide-miology and biostatistics). N Engl J Med 11:987–998
doi: 10.1056/NEJMoa1209825