ABSTRACT
Objective To evaluate the respiration-induced target volume motion in 3D-CRT for mid-thoracic esophageal carcinoma in order to guide the radiation oncologist to choose the expansion marginfor ITV.Methods Ten patients with mid-thoracic esophageal carcinoma were scanned by multi-spiral CTsimulator respectively in free breathing(FB),breath.hold after normal inspiration and expiration(IBH and EBH)with the same scanning range.Then the CT images of three series were transfefred to the treatmentplanning system.The target volume was outlined following the same standard.The motion of the centerpoint of GTV,the center point of each slice of GTV and the edge of the GTV in selected slice weremeasured respectively to obtain the comprehensive value of GTV motion。in order to find the appropriate IMvalue according to the 95％confidence interval of the GTV motion.Results①The GTV motion betweenIBH and EBH was(0.19±0.16)cm in the left.right direction,(0.54±0.19)cm in the cranial andcaudal irection.and(0.16±0.14)cm in anterior.posterior directions for the center of GTV,.For thecenter point of each slice of GTV.they ere(0.19±0.15)cm,(0.54±0.16)cm,(0.16±0.13)cm in three directions above.respectively.For the edge of the GTV in selected slice.they were(0.26±0.19)cm,(0.54±0.18)cm,(0.24±0.19)cm,respectively.The comprehensive value of GTV motion between IBH and EBH was(0.23±0.17)cm,(0.54±0.17)cm,(0.21±0.17)cm.respectively.The 95％confidence interval was 0.21-0.25 cm.0.53-0.56 cm and 0.19-0.22 cm in three directions.②The direction of GTV motion：No motion was noticed in 8.2％.while 73.3％to the right side and 18.5％to the left side in the left-right direction when IBH were compared with EBH.100％were moved to caudal in the the cranial and caudal direction[(0.54±0.17)cm].In the anterior-posterior direction,no motion was noticed in 8.2％,while 16.6％to the posterior and 75.2％to the anterior when IBH were compared with EBH.③The GTV motion was correlated with the vafiance of 1ung volumes in IBH-EBH(r=0.683,P=0.032)and not with GTV volume and length.Conclusions Respiration can induce target volume motion in 3 DCRT for mid-thoracic esophageal carcinoma.Compared to EBH.the GTV tends to move to the caudal,the anterior and the ight side in IBH.
ABSTRACT
Objective To evaluate the respiration-induced dosimetric variance in 3DCRT for midthoracic esophageal carcinoma, in order to guide the radiation oncologist to choose the expansion margin. Methods Ten patients with mid-thoracic esophageal carcinoma were scanned by multi-spiral CT simulator respectively in free breathing ( FB), breath-hold after normal inspiration and expiration ( IBH and EBH )with the same scanning range. Then the CT images of three series were transferred to the treatment planning system. The target volume was outlined following the same standard. Plan1 was designed in the images of FB and transported completely to the images of IBH and EBH as Plan2 and Plan3 respectively to observe the dosimetric variance in target volume. Results For GTV, there was a statistical difference only in V100 of the three plans ( H = 6.423, P = 0.040 ) and no significant difference was found in other indexes. For CTV, the V100 and V95 were better in Plan1 (F=3.992, P=0.030; H=9.920, P=0.007) and no significant difference was found in other indexes. While ()TV, the Dmin, V100 and V95 was better in Plan1 ( F = 3.677, P = 0.039; F = 4.539, P = 0.020; H = 6.846, P = 0.033 ) and no significant difference was found in other indexes. There were no significant differences in all the indexes for the spinal cord and lung in the three plans. Conclusions The change in dose distribution was not so much with the standard expansion. It can meet the needs of clinical treatment.
ABSTRACT
Purpose:To explore the regularity of lymph node metastasis in thoracic esophageal carcinoma.Methods:From March 2000 to June 2001,100 patients with thoracic esophageal carcinoma underwent radical esophagectomy with three field lymphadenectomy. Dissection was done through a right lateral thoracotomy followed by repositioning and simultaneous laparotomy and neck incision. Results:The hospital mortality rate was 0%.Nodal metastases occurred in 54% (54/100) of patients. The rate of metastasis to neck, mediastinum and abdomen were 31%, 34% and 26%. Cervical nodal metastasis was not correlated with the depth of tumor penetration. There was a higher frequency in nodal metastasis near the bilateral recurrent laryngeal nerves than that in the bilateral supraclavicular region. Conclusions:①Neck, mediastinum and abdomen nodal metastases occurred frequenthy in thoracic esophageal carcinoma. ②Cervical nodal metastasis could occur in early stage of tumor infiltration.③Cervical lymphadenectomy was a very important factor for accurate staging of thoracic esophageal cancer.
ABSTRACT
From October 1969 through December 1981, 3483 esoghageal carcinomas without superficial lymphatic metastasis were treated by 60 Co in our hospital. The radiation dose was over 50Gy and follow-up was over ten years. Results: No significant difference of survival rates was found in various cancer locations in the esophagus combined with the data between our hospital and Xingtai Tumor Hospital, the 5-year survival rates for lower third esophageal cancer were 20.7%～36.4% in surgery group and only 4.3% in radiation group. The 5-year survival rates were also significantly diffrent between radiation group(34.7%) and surgery group (64.9%) for cancer length of