scholarly journals Gross tumor volume is the prognostic factor for squamous cell esophageal cancer patients treated with definitive radiotherapy

2016 ◽  
Vol 8 (6) ◽  
pp. 1155-1161 ◽  
Author(s):  
Yun Chen ◽  
Zhen Zhang ◽  
Guoliang Jiang ◽  
Kuaile Zhao
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Squamous Cell ◽  
Gross Tumor Volume ◽  
Tumor Volume ◽  
Definitive Radiotherapy ◽  
Squamous Cell Esophageal Cancer

scholarly journals Interobserver variability in target volume delineation in definitive radiotherapy for thoracic esophageal cancer: a multi-center study from China

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiao Chang ◽  
Wei Deng ◽  
Xin Wang ◽  
Zongmei Zhou ◽  
Jun Yang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Gross Tumor Volume ◽  
Tumor Volume ◽  
Interobserver Variability ◽  
Target Volume ◽  
Thoracic Esophageal Cancer ◽  
Target Volume Delineation ◽  
Cancer Centers ◽  
Definitive Radiotherapy ◽  
Volume Delineation

Abstract Purpose To investigate the interobserver variability (IOV) in target volume delineation of definitive radiotherapy for thoracic esophageal cancer (TEC) among cancer centers in China, and ultimately improve contouring consistency as much as possible to lay the foundation for multi-center prospective studies. Methods Sixteen cancer centers throughout China participated in this study. In Phase 1, three suitable cases with upper, middle, and lower TEC were chosen, and participants were asked to contour a group of gross tumor volume (GTV-T), nodal gross tumor volume (GTV-N) and clinical target volume (CTV) for each case based on their routine experience. In Phase 2, the same clinicians were instructed to follow a contouring protocol to re-contour another group of target volume. The variation of the target volume was analyzed and quantified using dice similarity coefficient (DSC). Results Sixteen clinicians provided routine volumes, whereas ten provided both routine and protocol volumes for each case. The IOV of routine GTV-N was the most striking in all cases, with the smallest DSC of 0.37 (95% CI 0.32–0.42), followed by CTV, whereas GTV-T showed high consistency. After following the protocol, the smallest DSC of GTV-N was improved to 0.64 (95% CI 0.45–0.83, P = 0.005) but the DSC of GTV-T and CTV remained constant in most cases. Conclusion Variability in target volume delineation was observed, but it could be significantly reduced and controlled using mandatory interventions.

Post-radiation metabolic tumor volume (MTV) and survival in esophageal cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 9-9
Author(s):  
Alex Cruz ◽  
Michael D. Chuong ◽  
Jill M. Weber ◽  
Edward Eikman ◽  
Harry Lomas ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Surgical Resection ◽  
Tumor Volume ◽  
Metabolic Tumor Volume ◽  
Post Treatment ◽  
Pet Ct ◽  
Post Radiation

9 Background: PET-CT is an important tool for staging and evaluating treatment response in esophageal cancer. Metabolic tumor volume (MTV) has been reported as a prognostic factor in other malignancies. We evaluated the utility of post-radiation MTV in esophageal cancer patients treated with chemoradiotherapy (CRT). Methods: We evaluated pre- and post-treatment PET/CT scans in patients with squamous cell carcinoma (SCC) or adenocarcinoma (AC) treated with neoadjuvant/definitive intent. We measured the significance of the post-treatment MTV2.0-5.0 which was defined as the metabolic volume above a threshold SUV of x. Cox regression models were used to determine any significance between MTV2.0 -5.0 and disease free survival (DFS) or overall survival (OS). Multivariate analysis was performed. Results: We identified 63 patients (13 SCC, 50 AC) with a median follow-up of 12.0 months (range, 1.9-38.6). The median time to post-radiation PET/CT scan after completion of CRT was 40.1 days (range, 20-93). Thirty-seven (58.7%) patients underwent surgical resection. Univariate analysis revealed no significant correlation between post-treatment MTV and OS (MTV2.0 p = 0.968; MTV3.0 p = 0.945; MTV4.0 p = 0.890; MTV5.0 p = 0.316). There was also no significant correlation with respect to DFS (MTV2.0 p = 0.956; MTV3.0 p = 0.658; MTV4.0 p = 0.695; MTV5.0 p = 0.690). Multivariate analysis revealed that SCC histology and surgical resection were associated with improved OS while age, gender, post-radiation MTV2.0-5.0, and stage were not. Earlier stage and surgical resection were associated with improved DFS while post-radiation MTV2.0-5.0, age, gender, and histology were not. Conclusions: Although other studies have shown post-radiation MTV to be a significant prognostic factor, our data demonstrate no significant correlation with MTV and survival among esophageal cancer patients.

scholarly journals Interobserver variability in target volume delineation in definitive radiotherapy for thoracic esophageal cancer: A multi-center study from China

2020 ◽  
Author(s):  
Xiao Chang ◽  
Wei Deng ◽  
Xin Wang ◽  
Zongmei Zhou ◽  
Jun Yang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Gross Tumor Volume ◽  
Tumor Volume ◽  
Interobserver Variability ◽  
Target Volume ◽  
Thoracic Esophageal Cancer ◽  
Target Volume Delineation ◽  
Cancer Centers ◽  
Definitive Radiotherapy ◽  
Volume Delineation

Abstract Purpose: To investigate the interobserver variability (IOV) in target volume delineation of definitive radiotherapy for thoracic esophageal cancer (TEC) among cancer centers in China, and ultimately improve contouring consistency as much as possible to lay the foundation for multi-center prospective studies.Methods: Sixteen cancer centers throughout China participated in this study. In Phase 1, three suitable cases with upper, middle, and lower TEC were chosen, and participants were asked to contour a group of gross tumor volume (GTV-T), nodal gross tumor volume (GTV-N) and clinical target volume (CTV) for each case based on their routine experience. In Phase 2, the same clinicians were instructed to follow a contouring protocol to re-contour another group of target volume. The variation of the target volume was analyzed and quantified using dice similarity coefficient (DSC).Results: Sixteen clinicians provided routine volumes, whereas ten provided both routine and protocol volumes for each case. The IOV of routine GTV-N was the most striking in all cases, with the smallest DSC of 0.37 (95% CI: 0.32-0.42), followed by CTV, whereas GTV-T showed high consistency. After following the protocol, the smallest DSC of GTV-N was improved to 0.64 (95% CI: 0.45-0.83, P=0.005) but the DSC of GTV-T and CTV remained constant in most cases.Conclusion: Variability in target volume delineation was observed, but it could be significantly reduced and controlled using mandatory interventions.

PS02.121: INTENSIFIED IMRTWITH CARBOPLATIN AND PACLITAXEL IN LOCALLY ADVANCED ESOPHAGEAL CANCER: AN ANALYSIS ON EARLY OUTCOME

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 155-155
Author(s):  
Roberto Innocente ◽  
Federico Navarria ◽  
Elisa Palazzari ◽  
Fabio Matrone ◽  
Eleonora Farina ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Gross Tumor Volume ◽  
Tumor Volume ◽  
Locally Advanced ◽  
Complete Response ◽  
Advanced Esophageal Cancer ◽  
Locally Advanced Esophageal Cancer

Abstract Background Evaluate safety, feasibility and efficacy of an intesified IMRT and concomitant carboplatin and paclitaxel-based chemotherapy (Carbo/Tax CT) in patients (pts) with locally advanced esophageal cancer (LAEC) treated at our Institution Methods We retrospectively analyzed acute toxicity (according to CTCAE 4.0 scale), compliance and response to treatment in a series of consecutive patients treated, between February 2016 and February 2018, with intensified radiotherapy (IMRT) and weekly concurrent carboplatin and paclitaxel-based chemotherapy (CT) according to the CROSS trial. Results Thirty-four consecutive pts, 30(88%) males and 4 (12%) females, were treated. The median age was 68.5 yrs (range 46–83) and the ECOG Performance status ranged from 0 to 2. The diagnosis was adenocarcinoma in 15 pts (44%), squamous-cell carcinoma in 18 pts (53%) and undifferentiated carcinoma in 1 pt (3%). Two pts (6%) had a T2, 26 pts (76.4%) a T3 and 6 pts (17.6%) a T4 disease, respectively; 5 pts (15%) were N0, 21 pts (62%) N1 and 8 pts (23%) N2, respectively. Tumor involved the cervical esophagus in 3 pts (9%), the thoracic esophagus in 24 pts (70.5%) and the gastroesophageal junction in 7(20.5%). All pts underwent concurrent chemoradiotherapy (CRT), with IMRT technique, consisting of 45 Gy/25 frs to PTV1 (the primary gross tumor volume and the regional nodes), a simultaneous integrated boost ranging from 52.5Gy to 54Gy to PTV2 (gross tumor volume) and weekly concurrent carboplatin (AUC2) and paclitaxel (50mg/m2). Induction CT was administered to 6 pts. All pts completed the RT schedule. The median number of CT cycles was 3 (range 1–5) and 11 pts (32%) received 4 to 5 cycles of CT. Two adverse reactions to paclitaxel were reported. There were no major non-hematological adverse effects, the most common were nausea and vomiting (10%), and dysphagia (7%). Leukopenia was reported in 20 pts (71%), G3 in 2 pts (10%) and G2 in 18 (90%), respectively. G2 anemia occurred in 2 pts while G2 thrombocytopenia was reported in 3 pts (10%). Among the 30 evaluable pts (restaging is ongoing in 4 pts) a clinical complete response (PET, endoscopy and biopsy) was observed in 11 pts (37%), 7 with adenocarcinom and 4 with squamous cell carcinoma. Partial response was observed in 11 pts (37%) and 8 (26%) showed progressive disease. Total esophagectomy with radical lymphadenectomy, performed in 11 pts, showed a pathologic complete response in 6 pts (54%). Conclusion Intensified IMRT with concomitant Carbo/Tax CT in pts with LAEC seems to be safe and effective. These promising results need to be confirmed in all pts evaluated in this multimodality program Disclosure All authors have declared no conflicts of interest.

scholarly journals Interobserver variability in target volume delineation in definitive radiotherapy for thoracic esophageal cancer: A multi-center study from China

2020 ◽  
Author(s):  
Xiao Chang ◽  
Wei Deng ◽  
Xin Wang ◽  
Zongmei Zhou ◽  
Jun Yang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Gross Tumor Volume ◽  
Tumor Volume ◽  
Interobserver Variability ◽  
Target Volume ◽  
Thoracic Esophageal Cancer ◽  
Target Volume Delineation ◽  
Cancer Centers ◽  
Definitive Radiotherapy ◽  
Volume Delineation

Abstract Purpose: To investigate the interobserver variability (IOV) in target volume delineation of definitive radiotherapy for thoracic esophageal cancer (TEC) among cancer centers in China, and ultimately improve contouring consistency as much as possible to lay the foundation for multi-center prospective studies. Methods: Sixteen cancer centers throughout China participated in this study. In Phase 1, three suitable cases with upper, middle, and lower TEC were chosen, and participants were asked to contour a group of gross tumor volume (GTV-T), nodal gross tumor volume (GTV-N) and clinical target volume (CTV) for each case based on their routine experience. In Phase 2, the same clinicians were instructed to follow a contouring protocol to re-contour another group of target volume. The variation of the target volume was analyzed and quantified using dice similarity coefficient (DSC). Results: Sixteen clinicians provided routine volumes, whereas ten provided both routine and protocol volumes for each case. The IOV of routine GTV-N was the most striking in all cases, with the smallest DSC of 0.37 (95% CI: 0.32-0.42), followed by CTV, whereas GTV-T showed high consistency. After following the protocol, the smallest DSC of GTV-N was improved to 0.64 (95% CI: 0.45-0.83, P=0.005) but the DSC of GTV-T and CTV remained constant in most cases. Conclusion: Variability in target volume delineation was observed, but it could be significantly reduced and controlled using mandatory interventions.

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