Analysis of cardiac toxicity after definitive chemoradiotherapy for esophageal cancer using a biological dose-volume histogram
Analysis of cardiac toxicity after definitive chemoradiotherapy for esophageal cancer using a biological dose-volume histogram
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DOI：
10.1093/jrr/rraa001
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发表时间：
2020-03-01
影响因子：
2
通讯作者：
Nagata, Yasushi
中科院分区：
文献类型：
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作者：
Takeuchi, Yuki;Murakami, Yuji;Nagata, Yasushi
本研究旨在评价食管癌确定性放化疗（CRT）后心脏毒性与危及器官（OAR）剂量体积直方图（DVH）[使用生物有效剂量（BED）]之间的关系。我们分析了2001年至2016年期间使用确定性CRT治疗的83例食管癌患者的数据。此外，我们评价了心包积液（PE）作为心脏毒性的指标。中位总照射剂量为60（50.4 ~ 71）戈伊。12例（14%）患者出现症状性PE。有症状性肺栓塞组心脏和心包V5-V100（-BED）明显高于无症状性肺栓塞组（心脏：V5-V95（-BED），P <0.001; V100（-BED），P = 0.0053; V45-50（-BED），V100（-BED），P < 0.05）。受试者工作特征曲线分析显示，与心脏不良事件相关性最强的心包和心脏剂量-体积参数为V80（-BED），平均剂量和截断值分别为27.38%和61.7戈伊（-BED）。多因素分析显示，心包V80（-BED）和平均心脏剂量（-BED）是症状性PE的危险因素（P < 0.001）。我们使用基于BED的剂量-体积直方图揭示了OAR的辐照剂量与症状性PE之间的关系。顺铂V80（-BED）和平均心脏剂量（-BED）是症状性PE最相关的危险因素。
This study aimed to evaluate the relationship between cardiac toxicity after definitive chemoradiotherapy (CRT) for esophageal cancer and the dose-volume histogram (DVH) of organs at risk (OARs) [using biological effective dose (BED)]. We analyzed the data of 83 patients with esophageal cancer treated using definitive CRT between 2001 and 2016. Furthermore, we evaluated pericardial effusion (PE) as a measure of cardiac toxicity. The median total irradiation dose was 60 (50.4-71) Gy. Symptomatic PE was observedin 12 (14%) patients. The heart andpericardium V5-V100(-BED) were significantly higher in patients with symptomatic PE than in those without symptomatic PE (heart: V5-V95(-BED), P < 0.00 1 ; V100(-BED), P = 0.0053, and pericardium: V5-V40(-BED), V55-V95(-BED), P < 0.001; V45-50(-BED), V100(-BED), P < 0.05, respectively). Receiver operating characteristic curve analysis showed that the dose-volume parameter of the pericardium and the heart that was most strongly associated with an adverse cardiac event was V80(-BED), and the mean dose and the cut-off value were 27.38% and 61.7 Gy(-BED), respectively. Multivariate analysis showed that the pericardium V80(-BED) and the mean heart dose(-BED) were risk factors for symptomatic PE (P < 0.001, respectively). We revealed the relationship between the irradiated dose of the OARs and symptomatic PE using a BED-based dose-volume histogram. Pericardium V80(-BED) and mean heart dose(-BED) were the most relevant risk factors for symptomatic PE.