scholarly journals Fixed‐jaw technique to improve IMRT plan quality for the treatment of cervical and upper thoracic esophageal cancer

2019 ◽  
Vol 20 (10) ◽  
pp. 24-32
Author(s):  
Wei Song ◽  
Hong Lu ◽  
Jie Liu ◽  
Di Zhao ◽  
Jun Ma ◽  
...  
2015 ◽  
Vol 42 (6Part13) ◽  
pp. 3360-3360
Author(s):  
W Zhang ◽  
J Chen ◽  
T Zhai ◽  
L Yan ◽  
C Chen

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 10-10
Author(s):  
Yasunori Akutsu ◽  
Ken Kato ◽  
Hiroyasu Igaki ◽  
Yoshinori Ito ◽  
Isao Nozaki ◽  
...  

10 Background: Recently, a limited operation to avoid needless lymph node (LN) dissection in clinical T1bN0 esophageal cancer (EC) is considered. However, how LN dissection or radiation field should be decided for such cases has not yet been clarified. The information about prevalence of LN metastases (LNMs) would be valuable when the radiation field and extent of LN dissection are considered in the treatment of T1bN0 EC. Methods: JCOG0502 is a randomized controlled trial including a patient preference arm comparing surgery alone to definitive chemoradiotherapy in clinical T1bN0 EC. By using baseline clinical and pathological data of JCOG0502, diagnosis accuracy of LNM was evaluated by comparing clinical and pathologic findings. Then, the sites of pathologic LNMs were determined and the initial sites and the prevalence of LNM were estimated. Results: Between Dec 2006 and Feb 2013, 213 patients (pts) enrolled to the surgery arm in JCOG0502. Pts with multiple lesions or without esophagectomy were excluded and remaining 186 pts were analyzed. Of the 186 pts of clinical T1bN0, 137 pts were diagnosed as LNM negative (73.7%: accuracy of diagnosis), however, 49 pts (26.3%) had pathologic LNMs. Pathologic LNMs were seen at 106recR, 106recL (all in mediastinal region) in upper thoracic (Ut) EC, 101R, 101L, 104R, 104L (in the neck region), 106recR, 106recL, 106tbL, 105, 107, 108, 109L, 110 (in the mediastinal region), 1,2,3,7, 11 (in the abdominal region) in middle thoracic (Mt) EC, and 105, 106recL, 110 (in the mediastinal region), 1, 2, 3, 7 (in the abdominal region) in lower thoracic (Lt) EC, respectively. Of the 49 pts who had pathologic LNMs, 32 pts (65%) were of pathologically N2 or more. Furthermore, 18 pts (37%) had skip LNM (LNM of N2, N3 or N4 without N1). The solitary pathologic LNM was observed in 25 pts: N1 (106recR, 106recL) in Ut, N1 (106recR, 106recL, 108), N2 (101R, 105, 110, 1, 3, 7), in Mt, N1(110, 1), N2 (106recL, 3, 7) in Lt, respectively. Conclusions: In the current status of clinical diagnosis, limited LN dissection or limited field of radiation are not recommended. In surgery, D2 LN dissection is necessary and three-field LN dissection is recommended especially in middle thoracic EC even for clinical T1bN0. Clinical trial information: UMIN000000551.


PLoS ONE ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. e0121385 ◽  
Author(s):  
Wu-Zhe Zhang ◽  
Tian-Tian Zhai ◽  
Jia-Yang Lu ◽  
Jian-Zhou Chen ◽  
Zhi-Jian Chen ◽  
...  

2020 ◽  
Author(s):  
Zhao-Chong Zeng ◽  
Tai-wei Sun ◽  
Hong-jie He ◽  
Yan-ming Zhang ◽  
Shu-min Zhang ◽  
...  

Abstract Background An interesting clinical phenomenon occures frequently in our work, which indicates that blood pressure could return to normal in some hypertension patients with cervical & upper thoracic esophageal cancer undergoing radiotherapy. We speculated that this may be related to thyroid gland damage by radiotherapy.Methods We retrospectively analyzed pre- and post-radiotherapy (RT, 1.5months, 4.5months and 7.5months) systolic blood pressure (SBP) and diastolic blood pressure (DBP) for a cohort of esophageal cancer patients. At 7.5 months post-RT, serum free triiodothyronine (FT3), free tetraiodothyronine (FT4) and thyroid-stimulating hormone (TSH) concentrations were also measured to evaluate the changes of thyroid hormones (THs) and its correaltion with changes of blood pressure. To confirm the influence of radiation on thyroid, patients were divided into cervical & upper thoracic group (C&U, n=55) and middle & lower thoracic group (M&L, n=57). Results In the C&U group, the decreases (±SD) in SBP and DBP, respectively, were 5.51 mmHg (±1.83, P=0.003) and 3.62 mmHg (±1.38, P=0.002) at 1.5 months post-RT, 6.73 mmHg (±2.24, P=0.001) and 6.15 mmHg (±1.57, P=0.012) at 4.5 months post-RT, and 8.02 mmHg (±2.73, P<0.001) and 7.91 mmHg (±2.33, P<0.001) at 7.5 months post-RT. The corresponding decreases in the M&L group were not significant at any time post-RT. At 7.5 months post-RT, serum FT3 and FT4 concentrations in C&U group decreased significantly (P<0.05) from before RT to 7.5 months after the end of RT, and TSH concentration increased significantly after RT (P<0.05). In addition, Pearson analysis showed that both FT3 and FT4 was positively correlated with decrease of systolic BP (r= 0.430, P =0.001; r=0.667, P <0.001, respectively) and diastolic BP (r = 0.370, P =0.005; r = 0.469, P < 0.001 respectively). Conclusion The present study suggests that radiotherapy in patients with cervical and upper thoracic esophageal cancer might result in lowering BP, which might be related to thyroid gland damage by radiotherapy.


Sign in / Sign up

Export Citation Format

Share Document