Risk factors for enlargement of cardiac silhouette on chest radiography after radiotherapy for esophageal cancer.
Risk factors for enlargement of cardiac silhouette on chest radiography after radiotherapy for esophageal cancer.
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DOI：
10.1007/s11604-006-0050-1
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发表时间：
2006-07-01
影响因子：
--
通讯作者：
Sasai, Keisuke
中科院分区：
文献类型：
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作者：
Sasamoto, Ryuta;Tsuchida, Emiko;Sasai, Keisuke
目得：目的探讨食管癌放疗后胸部X线片上心脏阴影增大的发生率及危险因素。材料与方法：我们分析了67例食管癌患者，均接受总剂量≥ 50戈伊的外照射放疗，随访≥ 6个月。16名患者仅接受放射治疗，其余51名患者接受放化疗。治疗前胸片与治疗后最大心影胸片上的心胸比率（CTR）之间的差异被用于analysis.Results：CTR的平均最大增加为4.5%，这是统计学显著的。只有初始辐射场中的心脏轮廓面积是心脏轮廓扩大的重要风险因素。心包积液进行了计算机断层扫描与严重扩大的心脏sidewall.CONCLUSION：CTR值显着增加后，食管癌放疗的所有患者中观察到。放射性心包积液可能是心脏轮廓扩大的主要原因。受照射的心脏区域是心脏轮廓扩大的唯一显著危险因素;化疗的使用不是。
PURPOSE: To evaluate the incidence and risk factors of enlargement of cardiac silhouette on chest radiographs after radiotherapy for esophageal cancer.MATERIALS AND METHODS: We analyzed 67 patients with esophageal cancer who received external beam radiation therapy with a total dose of >or=50 Gy and were followed for >or=6 months. Sixteen patients received radiation alone, and the remaining 51 received chemoradiotherapy. The difference between the cardiothoracic ratio (CTR) on the pretreatment chest radiograph and that on the posttreatment radiograph with maximum cardiac silhouette for each patient was used for the analysis.RESULTS: The average maximum increase in CTR for the entire group was 4.5%, which was statistically significant. Only the area of the cardiac silhouette in the initial radiation field was a significant risk factor for enlargement of the cardiac silhouette. Pericardial effusions were observed in all patients who underwent computed tomography with severe enlargement of the cardiac silhouette.CONCLUSION: The CTR value significantly increased after radiotherapy for esophageal cancer. Radiation-induced pericardial effusion may be the main cause of enlargement of the cardiac silhouette. The irradiated cardiac area was the only significant risk factor for enlargement of the cardiac silhouette; the use of chemotherapy was not.