PURPOSE: This study examined the impact of gastric filling variation on target coverage of gastroesophageal junction (GEJ) tumors in three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), or IMRT with simultaneous integrated boost (IMRT-SIB) plans. MATERIALS AND METHODS: Eight patients previously receiving radiation therapy for esophageal cancer had computed tomography (CT) datasets acquired with full stomach (FS) and empty stomach (ES). We generated treatment plans for 3DCRT, IMRT, or IMRT-SIB for each patient on the ES-CT and on the FS-CT datasets. The 3DCRT and IMRT plans were planned to 50.4 Gy to the clinical target volume (CTV), and the same for IMRT-SIB plus 63.0 Gy to the gross tumor volume (GTV). Target coverage was evaluated using dose-volume histogram data for patient treatments simulated with ES-CT sets, assuming treatment on an FS for the entire course, and vice versa. RESULTS: FS volumes were a mean of 3.3 (range, 1.7-7.5) times greater than ES volumes. The volume of the GTV receiving >or=50.4 Gy (V(50.4Gy)) was 100% in all situations. The planning GTV V(63Gy) became suboptimal when gastric filling varied, regardless of whether simulation was done on the ES-CT or the FS-CT set. CONCLUSIONS: Stomach filling has a negligible impact on prescribed dose delivered to the GEJ GTV, using either 3DCRT or IMRT planning. Thus, local relapses are not likely to be related to variations in gastric filling. Dose escalation for GEJ tumors with IMRT-SIB may require gastric filling monitoring.
PURPOSE: This study examined the impact of gastric filling variation on target coverage of gastroesophageal junction (GEJ) tumors in three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), or IMRT with simultaneous integrated boost (IMRT-SIB) plans. MATERIALS AND METHODS: Eight patients previously receiving radiation therapy for esophageal cancer had computed tomography (CT) datasets acquired with full stomach (FS) and empty stomach (ES). We generated treatment plans for 3DCRT, IMRT, or IMRT-SIB for each patient on the ES-CT and on the FS-CT datasets. The 3DCRT and IMRT plans were planned to 50.4 Gy to the clinical target volume (CTV), and the same for IMRT-SIB plus 63.0 Gy to the gross tumor volume (GTV). Target coverage was evaluated using dose-volume histogram data for patient treatments simulated with ES-CT sets, assuming treatment on an FS for the entire course, and vice versa. RESULTS: FS volumes were a mean of 3.3 (range, 1.7-7.5) times greater than ES volumes. The volume of the GTV receiving >or=50.4 Gy (V(50.4Gy)) was 100% in all situations. The planning GTV V(63Gy) became suboptimal when gastric filling varied, regardless of whether simulation was done on the ES-CT or the FS-CT set. CONCLUSIONS: Stomach filling has a negligible impact on prescribed dose delivered to the GEJ GTV, using either 3DCRT or IMRT planning. Thus, local relapses are not likely to be related to variations in gastric filling. Dose escalation for GEJ tumors with IMRT-SIB may require gastric filling monitoring.
Authors: Shashank Acharya; Sourav Halder; Wenjun Kou; Peter J Kahrilas; John E Pandolfino; Neelesh A Patankar Journal: Comput Biol Med Date: 2021-10-15 Impact factor: 6.698
Authors: Jasmine A Oliver; Puja Venkat; Jessica M Frakes; Jason Klapman; Cynthia Harris; Jaime Montilla-Soler; Gautamy C Dhadham; Baderaldeen A Altazi; Geoffrey G Zhang; Eduardo G Moros; Ravi Shridhar; Sarah E Hoffe; Kujtim Latifi Journal: Endosc Int Open Date: 2017-05-31
Authors: Gustavo R Sarria; Hanna Schmitt; Lennart Jahnke; Daniel Bürgy; Frederik Wenz; Kerstin Siebenlist; Frank A Giordano; Anika Jahnke; Judit Boda-Heggemann Journal: Adv Radiat Oncol Date: 2020-10-13
Authors: Rhys Carrington; John Staffurth; Samantha Warren; Mike Partridge; Chris Hurt; Emiliano Spezi; Sarah Gwynne; Maria A Hawkins; Thomas Crosby Journal: Radiat Oncol Date: 2015-11-19 Impact factor: 3.481