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Safety of dose escalation by simultaneous integrated boosting radiation dose within the primary tumor guided by (18)FDG-PET/CT for esophageal cancer.
- Source :
-
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2015 Feb; Vol. 114 (2), pp. 195-200. Date of Electronic Publication: 2015 Jan 10. - Publication Year :
- 2015
-
Abstract
- Purpose: To observe the safety of selective dose boost to the pre-treatment high (18)F-deoxyglucose (FDG) uptake areas of the esophageal GTV.<br />Methods: Patients with esophageal squamous cell carcinoma were treated with escalating radiation dose of 4 levels, with a simultaneous integrated boost (SIB) to the pre-treatment 50% SUVmax area of the primary tumor. Patients received 4 monthly cycles of cisplatin and fluorouracil. Dose-limiting toxicity (DLT) was defined as any Grade 3 or higher acute toxicities causing continuous interruption of radiation for over 1 week.<br />Results: From April 2012 to February 2014, dose has been escalated up to LEVEL 4 (70Gy). All of the 25 patients finished the prescribed dose without DLT, and 10 of them developed Grade 3 acute esophagitis. One patient of LEVEL 2 died of esophageal hemorrhage within 1 month after completion of radiotherapy, which was not definitely correlated with treatment yet. Late toxicities remained under observation. With median follow up of 8.9months, one-year overall survival and local control was 69.2% and 77.4%, respectively.<br />Conclusions: Dose escalation in esophageal cancer based on (18)FDG-PET/CT has been safely achieved up to 70Gy using the SIB technique. Acute toxicities were well tolerated, whereas late toxicities and long-term outcomes deserved further observation.<br /> (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Carcinoma, Squamous Cell drug therapy
Cisplatin administration & dosage
Dose-Response Relationship, Radiation
Esophageal Neoplasms drug therapy
Esophageal Squamous Cell Carcinoma
Female
Fluorouracil administration & dosage
Humans
Male
Middle Aged
Multimodal Imaging methods
Positron-Emission Tomography methods
Radiopharmaceuticals
Tomography, X-Ray Computed methods
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carcinoma, Squamous Cell diagnostic imaging
Carcinoma, Squamous Cell radiotherapy
Esophageal Neoplasms diagnostic imaging
Esophageal Neoplasms radiotherapy
Fluorodeoxyglucose F18
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0887
- Volume :
- 114
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 25586952
- Full Text :
- https://doi.org/10.1016/j.radonc.2014.12.007