A preliminary study of relationship between incidental irradiation dose to lymph node stations and recurrence in esophageal cancer patients treated by involved-field irradiation
Shen Wenbi*,Gao Hongmei, Zhu Shuchai, Li Youmei, Li Shuguang, Cao Yankun, Su Jingwei, Liu Zhikun, Li Juan, Wen shiwan, Wu Yanzhao
*Departmentof Radiation Oncology, Forth Hospital, Hebei Medical University, Shijiazhaung 050011,China.
Abstract：Objective To investigate the relationship between the incidental irradiation dose (IID) to lymph node stations and recurrence in esophageal cancer (EC) patients treated by involved-field irradiation (IFI). Methods A retrospective analysis was performed on the clinical data of 81 EC patients who received radical radiotherapy from 2000 to 2004. The treatment failure mode, IID, and the relationship of IID with recurrence and long-term survival were analyzed. The Kaplan-Meier method was used to calculate overall survival (OS) and local control (LC) rates, and the log-rank test was used for survival difference analysis;the prognostic value of VPTV-NX was determined by receiver operating characteristic (ROC) analysis, and correlation analysis was performed by Spearman method. Results The follow-up rate was 100%. The 1-, 3-, 5-, and 8-year OS rates were 68%, 33%, 21%, and 11%, respectively, and the 1-, 3-, 5-, and 8-year LC rates were 77%, 46%, 36%, and 20%, respectively. After treatment, locoregional recurrence was found in 21 patients, distant metastasis in 15 patients, and recurrence and distant metastasis in 3 patients. The ROC analysis showed that VPTV-N40~50 could effectively predict out-field recurrence (P=0.004—0.031), and the optimal cut-off values were 71.5%, 68.5%, and 58.5%, respectively. VPTV-N40~50 had no significant correlation with long-term OS (P=0.601—0.f826), but showed a significant correlation with out-field recurrence (P=0.005—0.010). There was no significant correlationbetween VPTV-NX and grade ≥2 radiation injury (r=0.151－0.027,P=0.108—0.809). ConclusionsConsiderable IID to lymph node stations near EC may contribute to the prevention of subclinical lesions in EC patients treated by IFI.
Shen Wenbi*,Gao Hongmei,Zhu Shuchai et al. A preliminary study of relationship between incidental irradiation dose to lymph node stations and recurrence in esophageal cancer patients treated by involved-field irradiation[J]. Chinese Journal of Radiation Oncology, 2014, 23(4): 302-305.
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2014, Vol. 23 
