Individualized Radiation Dose Escalation Based on the Decrease in Tumor FDG Uptake and Normal Tissue Constraints Improve Survival in Patients With Esophageal Carcinoma
| Autor: | Wei Wang, Yaozong Dong, Zhaoyang Wang, Yipeng Song, Rukun Zang, Dong You, Chengde Wang, Wei Jiang, Jinbo Ma, Ercheng Chen |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Esophageal Neoplasms Normal tissue 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Fluorodeoxyglucose F18 Positron Emission Tomography Computed Tomography Carcinoma Humans Medicine Combined Modality Therapy In patient Treatment Failure Positron emission Precision Medicine Aged Neoplasm Staging Aged 80 and over business.industry Radiation dose Radiotherapy Dosage Articles Middle Aged Esophageal cancer Prognosis medicine.disease Treatment Outcome Oncology Response Evaluation Criteria in Solid Tumors 030220 oncology & carcinogenesis Female Radiology business Radiotherapy Image-Guided |
| Zdroj: | Technology in Cancer Research & Treatment. 16:75-80 |
| ISSN: | 1533-0338 1533-0346 |
| DOI: | 10.1177/1533034615627583 |
| Popis: | Background: To determine whether individualized radiation dose escalation after planned chemoradiation based on the decrease in tumor and normal tissue constraints can improve survival in patients with esophageal carcinoma. Methods: From August 2005 to December 2010, 112 patients with squamous esophageal carcinoma were treated with radical concurrent chemoradiation. Patients received positron emission tomography-computer tomography scan twice, before radiation and after radiation dose of 50.4 Gy. All patients were noncomplete metabolic response groups according to the Response Evaluation Criteria in solid tumors. Only 52 patients with noncomplete metabolic response received individualized dose escalation based on tumor and normal tissue constraints. Survival and treatment failure were observed and analyzed using SPSS (13.0). Results: The rate of complete metabolic response for patients with noncomplete metabolic response after dose escalation reached 17.3% (9 of 52). The 2-year overall survival rates for patients with noncomplete metabolic response in the conventional and dose-escalation groups were 20.5% and 42.8%, respectively( P = .001). The 2-year local control rates for patients were 35.7% and 76.2%, respectively ( P = .002). When patients were classified into partial metabolic response and no metabolic response, 2-year overall survival rates for patients with partial metabolic response were significantly different in conventional and dose-escalation groups (33.8% vs 78.4%; P = .000). The 2-year overall survival rates for patients with no metabolic response in two groups (8.6% vs 15.1%) did not significantly differ ( P = .917). Conclusion: Individualized radiation dose escalation has the potential to improve survival in patients with esophageal carcinoma according to increased rate of complete metabolic response. However, further trials are needed to confirm this and to identify patients who may benefit from dose escalation. |
| Databáze: | OpenAIRE |
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