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The Role of Modern Radiotherapy Technology in the Treatment of Esophageal Cancer

Radiation therapy (RT) has improved patient outcomes, but treatment-related complication rates remain high. In the conventional 2-dimensional and 3-dimensional conformal RT (3D-CRT) era, there was little room for toxicity reduction because of the need to balance the estimated toxicity to organs at r...

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Autores principales: Moon, Sung Ho, Suh, Yang-Gun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Thoracic and Cardiovascular Surgery 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409878/
https://www.ncbi.nlm.nih.gov/pubmed/32793450
http://dx.doi.org/10.5090/kjtcs.2020.53.4.184
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author Moon, Sung Ho
Suh, Yang-Gun
author_facet Moon, Sung Ho
Suh, Yang-Gun
author_sort Moon, Sung Ho
collection PubMed
description Radiation therapy (RT) has improved patient outcomes, but treatment-related complication rates remain high. In the conventional 2-dimensional and 3-dimensional conformal RT (3D-CRT) era, there was little room for toxicity reduction because of the need to balance the estimated toxicity to organs at risk (OARs), derived from dose-volume histogram data for organs including the lung, heart, spinal cord, and liver, with the planning target volume (PTV) dose. Intensity-modulated RT (IMRT) is an advanced form of conformal RT that utilizes computer-controlled linear accelerators to deliver precise radiation doses to the PTV. The dosimetric advantages of IMRT enable better sparing of normal tissues and OARs than is possible with 3D-CRT. A major breakthrough in the treatment of esophageal cancer (EC), whether early or locally advanced, is the use of proton beam therapy (PBT). Protons deposit their highest dose of radiation at the tumor, while leaving none behind; the resulting effective dose reduction to healthy tissues and OARs considerably reduces acute and delayed RT-related toxicity. In recent studies, PBT has been found to alleviate severe lymphopenia resulting from combined chemo-radiation, opening up the possibility of reducing immune suppression, which might be associated with a poor prognosis in cases of locally advanced EC.
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spelling pubmed-74098782020-08-12 The Role of Modern Radiotherapy Technology in the Treatment of Esophageal Cancer Moon, Sung Ho Suh, Yang-Gun Korean J Thorac Cardiovasc Surg Collective of current Review, Lecture Radiation therapy (RT) has improved patient outcomes, but treatment-related complication rates remain high. In the conventional 2-dimensional and 3-dimensional conformal RT (3D-CRT) era, there was little room for toxicity reduction because of the need to balance the estimated toxicity to organs at risk (OARs), derived from dose-volume histogram data for organs including the lung, heart, spinal cord, and liver, with the planning target volume (PTV) dose. Intensity-modulated RT (IMRT) is an advanced form of conformal RT that utilizes computer-controlled linear accelerators to deliver precise radiation doses to the PTV. The dosimetric advantages of IMRT enable better sparing of normal tissues and OARs than is possible with 3D-CRT. A major breakthrough in the treatment of esophageal cancer (EC), whether early or locally advanced, is the use of proton beam therapy (PBT). Protons deposit their highest dose of radiation at the tumor, while leaving none behind; the resulting effective dose reduction to healthy tissues and OARs considerably reduces acute and delayed RT-related toxicity. In recent studies, PBT has been found to alleviate severe lymphopenia resulting from combined chemo-radiation, opening up the possibility of reducing immune suppression, which might be associated with a poor prognosis in cases of locally advanced EC. The Korean Society for Thoracic and Cardiovascular Surgery 2020-08-05 2020-08-05 /pmc/articles/PMC7409878/ /pubmed/32793450 http://dx.doi.org/10.5090/kjtcs.2020.53.4.184 Text en Copyright © The Korean Society for Thoracic and Cardiovascular Surgery. 2020. All right reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Collective of current Review, Lecture
Moon, Sung Ho
Suh, Yang-Gun
The Role of Modern Radiotherapy Technology in the Treatment of Esophageal Cancer
title The Role of Modern Radiotherapy Technology in the Treatment of Esophageal Cancer
title_full The Role of Modern Radiotherapy Technology in the Treatment of Esophageal Cancer
title_fullStr The Role of Modern Radiotherapy Technology in the Treatment of Esophageal Cancer
title_full_unstemmed The Role of Modern Radiotherapy Technology in the Treatment of Esophageal Cancer
title_short The Role of Modern Radiotherapy Technology in the Treatment of Esophageal Cancer
title_sort role of modern radiotherapy technology in the treatment of esophageal cancer
topic Collective of current Review, Lecture
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409878/
https://www.ncbi.nlm.nih.gov/pubmed/32793450
http://dx.doi.org/10.5090/kjtcs.2020.53.4.184
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