Risk factors for pericardial effusion in inoperable esophageal cancer patients treated with definitive chemoradiation therapy
Risk factors for pericardial effusion in inoperable esophageal cancer patients treated with definitive chemoradiation therapy
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DOI：
10.1016/j.ijrobp.2007.10.056
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发表时间：
2008-03-01
影响因子：
7
通讯作者：
Liao, Zhongxing
中科院分区：
文献类型：
--
作者：
Wei, Xiong;Liu, H. Helen;Liao, Zhongxing
目的：确定临床和剂量学因素影响心包积液（PCE）的风险与明确的同步化疗和放疗（RT）治疗的食管癌患者的治疗方法和材料：资料为101例不能手术的食管癌患者同步化疗和RT从2000年至2003年在我们的机构进行了分析。PCE从随访胸部计算机断层扫描和放射学报告中得到证实，从RT结束时开始计算无PCE。使用对数秩检验来确定影响无PCE的临床和剂量学因素。结果：101例患者中PCE的粗率为27.7%（28/101）。中位时间发生的PCE为5.3个月（范围，1.0-16.7个月）后RT。没有临床因素的研究被发现显着影响PCE的风险。在单变量分析中，心包和心脏的广泛剂量-体积直方图参数与PCE风险相关，包括心包的平均剂量、接受剂量大于3戈伊（V3）至大于50戈伊（V50）的心包体积和接受治疗的心脏体积大于32-38戈伊。多因素分析选择V30作为唯一与PCE风险显著相关的参数。结论：高剂量辐射心包可能强烈增加PCE的风险。这种风险可以通过最小化被照射的心包和心脏的剂量体积来降低。(c)2008年爱思唯尔公司
Purpose: To identify clinical and dosimetric factors influencing the risk of pericardial effusion (PCE) in patients with inoperable esophageal cancer treated with definitive concurrent chemotherapy and radiation therapy (RT).Methods and Materials: Data for 101 patients with inoperable esophageal cancer treated with concurrent chemotherapy and RT from 2000 to 2003 at our institution were analyzed. The PCE was confirmed from follow-up chest computed tomography scans and radiologic reports, with freedom from PCE computed from the end of RT. Log-rank tests were used to identify clinical and dosimetric factors influencing freedom from PCE. Dosimetric factors were calculated from the dose-volume histogram for the whole heart and pericardium.Results: The crude rate of PCE was 27.7% (28 of 101). Median time to onset of PCE was 5.3 months (range, 1.0-16.7 months) after RT. None of the clinical factors investigated was found to significantly influence the risk of PCE. In univariate analysis, a wide range of dose-volume histogram parameters of the pericardium and heart were associated with risk of PCE, including mean dose to the pericardium, volume of pericardium receiving a dose greater than 3 Gy (V3) to greater than 50 Gy (V50), and heart volume treated to greater than 32-38 Gy. Multivariate analysis selected V30 as the only parameter significantly associated with risk of PCE.Conclusions: High-dose radiation to the pericardium may strongly increase the risk of PCE. Such a risk may be reduced by minimizing the dose-volume of the irradiated pericardium and heart. (c) 2008 Elsevier Inc.