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Prognostic significance of lung radiation dose in patients with esophageal cancer treated with neoadjuvant chemoradiotherapy

BACKGROUND: The prognostic significance of radiation dose to the lung or heart is unknown in esophageal cancer patients receiving neoadjuvant chemoradiotherapy followed by surgery (trimodal therapy). This study aimed to determine the association between lung and heart radiation dose volumes and prog...

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Autores principales: Lin, Jhen-Bin, Hung, Li-Chung, Cheng, Ching-Yuan, Chien, Yu-An, Lee, Chou-Hsien, Huang, Chia-Chun, Chou, Tsai-Wei, Ko, Ming-Huei, Lai, Yuan-Chun, Liu, Mu-Tai, Chang, Tung-Hao, Lee, Jie, Chen, Yu-Jen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534831/
https://www.ncbi.nlm.nih.gov/pubmed/31126307
http://dx.doi.org/10.1186/s13014-019-1283-3
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author Lin, Jhen-Bin
Hung, Li-Chung
Cheng, Ching-Yuan
Chien, Yu-An
Lee, Chou-Hsien
Huang, Chia-Chun
Chou, Tsai-Wei
Ko, Ming-Huei
Lai, Yuan-Chun
Liu, Mu-Tai
Chang, Tung-Hao
Lee, Jie
Chen, Yu-Jen
author_facet Lin, Jhen-Bin
Hung, Li-Chung
Cheng, Ching-Yuan
Chien, Yu-An
Lee, Chou-Hsien
Huang, Chia-Chun
Chou, Tsai-Wei
Ko, Ming-Huei
Lai, Yuan-Chun
Liu, Mu-Tai
Chang, Tung-Hao
Lee, Jie
Chen, Yu-Jen
author_sort Lin, Jhen-Bin
collection PubMed
description BACKGROUND: The prognostic significance of radiation dose to the lung or heart is unknown in esophageal cancer patients receiving neoadjuvant chemoradiotherapy followed by surgery (trimodal therapy). This study aimed to determine the association between lung and heart radiation dose volumes and prognosis of esophageal cancer after trimodal therapy. METHODS: This study reviewed 123 esophageal cancer patients treated with trimodal therapy in two tertiary institutions between 2010 and 2015. The dose-volume histogram parameter of Vx was defined as the percentage of total organ volume receiving a radiation dose of x (Gy) or more. Predictors of overall survival (OS) were identified using Cox regression models. Receiver-operating characteristic curves were used to select cut-off values for dose-volume. RESULTS: Median follow-up was 28.3 months (range: 4.7–92.8 months). Median OS and progression-free survival were 34.0 months (95% confidence interval [CI]: 27.4–40.6 months) and 24.8 months (95% CI, 18.9–30.7 months), respectively. Multivariate analyses showed that lung V20 (hazard ratio, 1.09; 95% CI: 1.04–1.14; p < 0.001) and lung V5 (hazard ratio, 1.02; 95% CI: 1.00–1.05; p = 0.03) were associated with OS when adjusting for surgical margin and pathological treatment response. The 5-year OS for patients with lung V20 ≤ 23% vs. patients with lung V20 > 23% was 54.4% vs. 5% (p < 0.001) whereas that for patients with lung V5 ≤ 56% vs. patients with lung V5 > 56% was 81.5% vs. 23.4% (p < 0.001). Mean heart dose showed no association with survival outcomes. CONCLUSIONS: Lung radiation dose was independently associated with survival outcomes in esophageal cancer patients treated with neoadjuvant chemoradiotherapy and surgery. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13014-019-1283-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-65348312019-05-28 Prognostic significance of lung radiation dose in patients with esophageal cancer treated with neoadjuvant chemoradiotherapy Lin, Jhen-Bin Hung, Li-Chung Cheng, Ching-Yuan Chien, Yu-An Lee, Chou-Hsien Huang, Chia-Chun Chou, Tsai-Wei Ko, Ming-Huei Lai, Yuan-Chun Liu, Mu-Tai Chang, Tung-Hao Lee, Jie Chen, Yu-Jen Radiat Oncol Research BACKGROUND: The prognostic significance of radiation dose to the lung or heart is unknown in esophageal cancer patients receiving neoadjuvant chemoradiotherapy followed by surgery (trimodal therapy). This study aimed to determine the association between lung and heart radiation dose volumes and prognosis of esophageal cancer after trimodal therapy. METHODS: This study reviewed 123 esophageal cancer patients treated with trimodal therapy in two tertiary institutions between 2010 and 2015. The dose-volume histogram parameter of Vx was defined as the percentage of total organ volume receiving a radiation dose of x (Gy) or more. Predictors of overall survival (OS) were identified using Cox regression models. Receiver-operating characteristic curves were used to select cut-off values for dose-volume. RESULTS: Median follow-up was 28.3 months (range: 4.7–92.8 months). Median OS and progression-free survival were 34.0 months (95% confidence interval [CI]: 27.4–40.6 months) and 24.8 months (95% CI, 18.9–30.7 months), respectively. Multivariate analyses showed that lung V20 (hazard ratio, 1.09; 95% CI: 1.04–1.14; p < 0.001) and lung V5 (hazard ratio, 1.02; 95% CI: 1.00–1.05; p = 0.03) were associated with OS when adjusting for surgical margin and pathological treatment response. The 5-year OS for patients with lung V20 ≤ 23% vs. patients with lung V20 > 23% was 54.4% vs. 5% (p < 0.001) whereas that for patients with lung V5 ≤ 56% vs. patients with lung V5 > 56% was 81.5% vs. 23.4% (p < 0.001). Mean heart dose showed no association with survival outcomes. CONCLUSIONS: Lung radiation dose was independently associated with survival outcomes in esophageal cancer patients treated with neoadjuvant chemoradiotherapy and surgery. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13014-019-1283-3) contains supplementary material, which is available to authorized users. BioMed Central 2019-05-24 /pmc/articles/PMC6534831/ /pubmed/31126307 http://dx.doi.org/10.1186/s13014-019-1283-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Lin, Jhen-Bin
Hung, Li-Chung
Cheng, Ching-Yuan
Chien, Yu-An
Lee, Chou-Hsien
Huang, Chia-Chun
Chou, Tsai-Wei
Ko, Ming-Huei
Lai, Yuan-Chun
Liu, Mu-Tai
Chang, Tung-Hao
Lee, Jie
Chen, Yu-Jen
Prognostic significance of lung radiation dose in patients with esophageal cancer treated with neoadjuvant chemoradiotherapy
title Prognostic significance of lung radiation dose in patients with esophageal cancer treated with neoadjuvant chemoradiotherapy
title_full Prognostic significance of lung radiation dose in patients with esophageal cancer treated with neoadjuvant chemoradiotherapy
title_fullStr Prognostic significance of lung radiation dose in patients with esophageal cancer treated with neoadjuvant chemoradiotherapy
title_full_unstemmed Prognostic significance of lung radiation dose in patients with esophageal cancer treated with neoadjuvant chemoradiotherapy
title_short Prognostic significance of lung radiation dose in patients with esophageal cancer treated with neoadjuvant chemoradiotherapy
title_sort prognostic significance of lung radiation dose in patients with esophageal cancer treated with neoadjuvant chemoradiotherapy
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534831/
https://www.ncbi.nlm.nih.gov/pubmed/31126307
http://dx.doi.org/10.1186/s13014-019-1283-3
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