首页> 外文期刊>International Journal of Radiation Oncology, Biology, Physics >Risk factors for pericardial effusion in inoperable esophageal cancer patients treated with definitive chemoradiation therapy.
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Risk factors for pericardial effusion in inoperable esophageal cancer patients treated with definitive chemoradiation therapy.

机译:彻底放化疗治疗无法手术的食管癌患者心包积液的危险因素。

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摘要

PURPOSE: To identify clinical and dosimetric factors influencing the risk of pericardial effusion (PCE) in patients with inoperable esophageal cancer treated with definitive concurrent chemotherapy and radiation therapy (RT). METHODS AND MATERIALS: Data for 101 patients with inoperable esophageal cancer treated with concurrent chemotherapy and RT from 2000 to 2003 at our institution were analyzed. The PCE was confirmed from follow-up chest computed tomography scans and radiologic reports, with freedom from PCE computed from the end of RT. Log-rank tests were used to identify clinical and dosimetric factors influencing freedom from PCE. Dosimetric factors were calculated from the dose-volume histogram for the whole heart and pericardium. RESULTS: The crude rate of PCE was 27.7% (28 of 101). Median time to onset of PCE was 5.3 months (range, 1.0-16.7 months) after RT. None of the clinical factors investigated was found to significantly influence the risk of PCE. In univariate analysis, a wide range of dose-volume histogram parameters of the pericardium and heart were associated with risk of PCE, including mean dose to the pericardium, volume of pericardium receiving a dose greater than 3 Gy (V3) to greater than 50 Gy (V50), and heart volume treated to greater than 32-38 Gy. Multivariate analysis selected V30 as the only parameter significantly associated with risk of PCE. CONCLUSIONS: High-dose radiation to the pericardium may strongly increase the risk of PCE. Such a risk may be reduced by minimizing the dose-volume of the irradiated pericardium and heart.
机译:目的:确定影响终末期联合化疗和放射治疗(RT)的无法手术的食管癌患者心包积液(PCE)风险的临床和剂量学因素。方法与材料:分析我院2000年至2003年间101例不能同时手术并放化疗的食管癌患者的资料。通过随访胸部计算机体层摄影术扫描和放射学报告证实了PCE,而从RT结束算起没有PCE。使用对数秩检验来确定影响PCE自由度的临床和剂量学因素。从整个心脏和心包的剂量-体积直方图计算剂量系数。结果:PCE的原油率为27.7%(101之28)。 RT后PCE发病的中位时间为5.3个月(1.0-16.7个月)。没有发现所研究的临床因素会显着影响PCE的风险。在单变量分析中,心包和心脏的各种剂量体积直方图参数与PCE风险相关,包括心包平均剂量,接受大于3 Gy(V3)至大于50 Gy剂量的心包体积(V50),并且心脏体积大于32-38 Gy。多变量分析选择V30作为与PCE风险显着相关的唯一参数。结论:大剂量辐射至心包可能会大大增加PCE的风险。通过最小化被照射的心包和心脏的剂量体积可以降低这种风险。

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