The effect of dose escalation on gastric toxicity when treating lower oesophageal tumours: a radiobiological investigation.
The effect of dose escalation on gastric toxicity when treating lower oesophageal tumours: a radiobiological investigation.
Purpose: using radiobiological modelling to estimate normal tissue toxicity, this study investigates the effects of dose escalation for concurrent chemoradiation therapy (CRT) in lower third oesophageal tumours on the stomach.
Methods and materials: 10 patients with lower third oesophageal cancer were selected from the SCOPE 1 database (ISCRT47718479) with a mean planning target volume (PTV) of 348 cm3. The original 3D conformal plans (50Gy3D) were compared to newly created RapidArc plans of 50GyRA and 60GyRA, the latter using a simultaneous integrated boost (SIB) technique using a boost volume, PTV2. Dose-volume metrics and estimates of normal tissue complication probability (NTCP) were compared.
Results
There was a significant increase in NTCP of the stomach wall when moving from the 50GyRA to the 60GyRA plans (11–17 %, Wilcoxon signed rank test, p = 0.01). There was a strong correlation between the NTCP values of the stomach wall and the volume of the stomach wall/PTV 1 and stomach wall/PTV2 overlap structures (R = 0.80 and R = 0.82 respectively) for the 60GyRA plans.
Conclusion: radiobiological modelling suggests that increasing the prescribed dose to 60Gy may be associated with a significantly increased risk of toxicity to the stomach. It is recommended that stomach toxicity be closely monitored when treating patients with lower third oesophageal tumours with 60Gy.
Carrington, Rhys
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Staffurth, John
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Warren, Samantha
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Partridge, Mike
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Hurt, Chris
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Spezi, Emiliano
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Gwynne, Sarah
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Hawkins, Maria A.
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Crosby, Thomas
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19 November 2015
Carrington, Rhys
9f5dc419-18d2-4e35-8521-bd077081cdd8
Staffurth, John
db58e06d-eb84-485a-8656-ea5d48ba548e
Warren, Samantha
5724cc3d-1b47-4866-beb9-a1d16ad48ac8
Partridge, Mike
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Hurt, Chris
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Spezi, Emiliano
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Gwynne, Sarah
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Hawkins, Maria A.
fe46c6fb-a77c-4308-8861-48b34a65c2f3
Crosby, Thomas
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Carrington, Rhys, Staffurth, John, Warren, Samantha, Partridge, Mike, Hurt, Chris, Spezi, Emiliano, Gwynne, Sarah, Hawkins, Maria A. and Crosby, Thomas
(2015)
The effect of dose escalation on gastric toxicity when treating lower oesophageal tumours: a radiobiological investigation.
Radiation Oncology, 10, [236].
(doi:10.1186/s13014-015-0537-y).
Abstract
Purpose: using radiobiological modelling to estimate normal tissue toxicity, this study investigates the effects of dose escalation for concurrent chemoradiation therapy (CRT) in lower third oesophageal tumours on the stomach.
Methods and materials: 10 patients with lower third oesophageal cancer were selected from the SCOPE 1 database (ISCRT47718479) with a mean planning target volume (PTV) of 348 cm3. The original 3D conformal plans (50Gy3D) were compared to newly created RapidArc plans of 50GyRA and 60GyRA, the latter using a simultaneous integrated boost (SIB) technique using a boost volume, PTV2. Dose-volume metrics and estimates of normal tissue complication probability (NTCP) were compared.
Results
There was a significant increase in NTCP of the stomach wall when moving from the 50GyRA to the 60GyRA plans (11–17 %, Wilcoxon signed rank test, p = 0.01). There was a strong correlation between the NTCP values of the stomach wall and the volume of the stomach wall/PTV 1 and stomach wall/PTV2 overlap structures (R = 0.80 and R = 0.82 respectively) for the 60GyRA plans.
Conclusion: radiobiological modelling suggests that increasing the prescribed dose to 60Gy may be associated with a significantly increased risk of toxicity to the stomach. It is recommended that stomach toxicity be closely monitored when treating patients with lower third oesophageal tumours with 60Gy.
Text
s13014-015-0537-y
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Accepted/In Press date: 4 November 2015
Published date: 19 November 2015
Identifiers
Local EPrints ID: 488292
URI: http://eprints.soton.ac.uk/id/eprint/488292
ISSN: 1748-717X
PURE UUID: 08ab5455-35c7-408a-acd1-19db45cda0bc
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Date deposited: 19 Mar 2024 18:05
Last modified: 18 Jun 2024 02:08
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Author:
Rhys Carrington
Author:
John Staffurth
Author:
Samantha Warren
Author:
Mike Partridge
Author:
Chris Hurt
Author:
Emiliano Spezi
Author:
Sarah Gwynne
Author:
Maria A. Hawkins
Author:
Thomas Crosby
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