ESOPHAGEAL STENOSIS ASSOCIATED WITH TUMOR REGRESSION IN RADIOTHERAPY FOR ESOPHAGEAL CANCER: FREQUENCY AND PREDICTION
ESOPHAGEAL STENOSIS ASSOCIATED WITH TUMOR REGRESSION IN RADIOTHERAPY FOR ESOPHAGEAL CANCER: FREQUENCY AND PREDICTION
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DOI：
10.1016/j.ijrobp.2011.01.047
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发表时间：
2012-04-01
影响因子：
7
通讯作者：
Honda, Hiroshi
中科院分区：
文献类型：
--
作者：
Atsumi, Kazushige;Shioyama, Yoshiyuki;Honda, Hiroshi
目的：确定预测食管癌放疗中与肿瘤消退相关的食管狭窄频率和严重程度的临床因素。
方法和材料：研究组包括109例T1 - 4期和I - III期食管癌患者，这些患者于1998年1月至2007年12月在九州大学医院接受根治性放疗，并使原发灶达到完全缓解。在放疗完成后3个月内使用食管造影图像评估食管狭窄情况。我们研究了放疗后食管狭窄与肿瘤和治疗相关的各个临床因素之间的相关性。为了验证食管狭窄的相关因素，使用人工神经网络预测食管狭窄率。
结果：T3 - 4期病例的食管狭窄往往比T1 - 2期更严重且更频繁。肿瘤累及全周的病例食管狭窄往往比未累及全周的更严重且更频繁。食管壁厚度增加往往与食管狭窄的严重程度和频率增加相关。在多变量分析中，T分期、累及周径范围以及肿瘤区域的食管壁厚度与食管狭窄显著相关（分别为p = 0.031，p < 0.0001和p = 0.0011）。学习了这三个因素的人工神经网络所预测的食管狭窄率与实际观察到的狭窄率显著相关，相关系数为0.864（p < 0.001）。
结论：我们的研究表明，肿瘤区域的T分期、累及周径范围以及食管壁厚度有助于预测食管癌放疗中与肿瘤消退相关的食管狭窄的频率和严重程度。（c）2012爱思唯尔公司
Purpose: To determine clinical factors for predicting the frequency and severity of esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer.Methods and Materials: The study group consisted of 109 patients with esophageal cancer of T1-4 and Stage I-III who were treated with definitive radiotherapy and achieved a complete response of their primary lesion at Kyushu University Hospital between January 1998 and December 2007. Esophageal stenosis was evaluated using esophagographic images within 3 months after completion of radiotherapy. We investigated the correlation between esophageal stenosis after radiotherapy and each of the clinical factors with regard to tumors and therapy. For validation of the correlative factors for esophageal stenosis, an artificial neural network was used to predict the esophageal stenotic ratio.Results: Esophageal stenosis tended to be more severe and more frequent in T3-4 cases than in T1-2 cases. Esophageal stenosis in cases with full circumference involvement tended to be more severe and more frequent than that in cases without full circumference involvement. Increases in wall thickness tended to be associated with increases in esophageal stenosis severity and frequency. In the multivariate analysis, T stage, extent of involved circumference, and wall thickness of the tumor region were significantly correlated to esophageal stenosis (p = 0.031, p < 0.0001, and p = 0.0011, respectively). The esophageal stenotic ratio predicted by the artificial neural network, which learned these three factors, was significantly correlated to the actual observed stenotic ratio, with a correlation coefficient of 0.864 (p < 0.001).Conclusion: Our study suggested that T stage, extent of involved circumference, and esophageal wall thickness of the tumor region were useful to predict the frequency and severity of esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer. (c) 2012 Elsevier Inc.