Does Radiation Dose to Gastric Fundus during Neoadjuvant Chemoradiotherapy for Esophageal Carcinoma Have an Impact on Postoperative Anastomotic Leak?
| Autor: | Radhakrishna N; Department of Radiation Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India., Sudha SP; Department of Radiation Oncology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), An Institution of National Importance, Government of India, Puducherry, India., Kalayarasan R; Department of Surgical Gastroenterology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), An Institution of National Importance, Government of India, Puducherry, India., Penumadu P; Department of Surgical Oncology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), An Institution of National Importance, Government of India, Puducherry, India. |
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| Jazyk: | angličtina |
| Zdroj: | Gastrointestinal tumors [Gastrointest Tumors] 2021 Jun; Vol. 8 (3), pp. 121-127. Date of Electronic Publication: 2021 Mar 17. |
| DOI: | 10.1159/000513929 |
| Abstrakt: | Background: Radiation dose received by the gastric fundus (GF) in neoadjuvant chemoradiotherapy (NACRT) may influence the development of postoperative anastomotic leak (AL) in the management of resectable esophageal carcinoma (EC) by trimodality therapy. The present study aims to evaluate dose-volume parameters of the GF and their association with occurrence of AL in EC. Materials and Methods: A retrospective analysis was performed of 27 patients with EC who underwent NACRT followed by esophagectomy with cervical esophagogastric anastomosis between January 2015 and July 2018. The GF was retrospectively contoured; dose-volume parameters of the GF were recorded. Postoperative AL was identified from surgical records. Logistic regression analysis was used to identify risk factors associated with AL. Results: The mean age of the patients was 51 ± 10.5 years; 56% (15/27) had involvement of lower 1/3 esophagus, 10/27 (37%) midthoracic esophagus, and 2/27 (7%) upper thoracic esophagus; 40% (11/27) patients developed postoperative AL and 7/11 had distal and 4/11 had mid thoracic esophageal lesions. Four of five (80%) patients treated by 3-dimensional conformal radiotherapy versus 7/22 (32%) patients treated by volumetric modulated arc therapy developed AL ( p = 0.12). Univariate logistic regression revealed no significant correlation between D Conclusion: There was no significant negative impact of the dose received by the GF in NACRT upon AL rates. Further studies with a larger sample size are required to clarify this issue. Competing Interests: The authors have no conflicts of interest to declare. (Copyright © 2021 by S. Karger AG, Basel.) |
| Databáze: | MEDLINE |
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