DOSE VOLUME HISTOGRAM PARAMETERS AND CLINICAL FACTORS ASSOCIATED WITH PLEURAL EFFUSION AFTER CHEMORADIOTHERAPY IN ESOPHAGEAL CANCER PATIENTS

作者：Shirai Katsuyuki^*; Tamaki Yoshio; Kitamoto Yoshizumi; Murata Kazutoshi; Satoh Yumi; Higuchi Keiko; Nonaka Tetsuo; Ishikawa Hitoshi; Katoh Hiroyuki; Takahashi Takeo; Nakano Takashi

来源：International Journal of Radiation Oncology, Biology, Physics, 2011, 80(4): 1002-1007.

DOI：10.1016/j.ijrobp.2010.03.046

• Pleural effusion
• Esophageal cancer
• Chemoradiotherapy
• Dose-volume histogram
• Heart

Purpose: To investigate the dose volume histogram parameters and clinical factors as predictors of pleural effusion in esophageal cancer patients treated with concurrent chemoradiotherapy (CRT).
Methods and Materials: Forty-three esophageal cancer patients treated with definitive CRT from January 2001 to March 2007 were reviewed retrospectively on the basis of the following criteria: pathologically confirmed esophageal cancer, available computed tomography scan for treatment planning, 6-month follow-up after CRT, and radiation dose >= 50 Gy. Exclusion criteria were lung metastasis, malignant pleural effusion, and surgery. Mean heart dose, mean total lung dose, and percentages of heart or total lung volume receiving >= 10-60 Gy (Heart-V-10 to V-60 and Lung-V-10 to V-60, respectively) were analyzed in relation to pleural effusion.
Results: The median follow-up time was 26.9 months (range, 6.7-70.2) after CRT. Of the 43 patients, 15(35%) developed pleural effusion. By univariate analysis, mean heart dose, Heart-V-10 to V-60, and Lung-V-50 to V-60 were significantly associated with pleural effusion. Poor performance status, primary tumor of the distal esophagus, and age years were significantly related with pleural effusion. Multivariate analysis identified Heart-V-50 as the strongest predictive factor for pleural effusion (p = 0.01). Patients with Heart-V-50 <20%, 20% Heart-V-50 <40%, and Heart-V5(0_) >= 40% had 6%, 44%, and 64% of pleural effusion, respectively (p < 0.01).
Conclusion: Heart-V-50 is a useful parameter for assessing the risk of pleural effusion and should be reduced to avoid pleural effusion.

• 出版日期2011-7-15