Intensity modulated radiation therapy with simultaneous integrated boost based dose escalation on neoadjuvant chemoradiation therapy for locally advanced distal esophageal adenocarcinoma

作     者：Ming Zeng Fernando N Aguila Taral Patel Mark Knapp XueQiang Zhu XiLin Chen Phillip D Price 

作者机构：Department of Radiation OncologyMount Carmel Health System Cancer CenterSichuan Academy of Medical SciencesSichuan Provincial Hospital Central Ohio Surgical AssociatesInc. Department of Hematology and OncologyZangmeister Cancer CenterMount Carmel Health System Department of Oncology307 Hospital 

出 版 物：《World Journal of Gastrointestinal Oncology》 (世界胃肠肿瘤学杂志（英文版）（电子版）)

年 卷 期：2016年第8卷第5期

页      面：474-480页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Intensity modulated radiation therapy Esophageal adenocarcinoma Simultaneous integrated boost Neoadjuvant chemoradiation Dose escalation Resection rate 

摘      要：AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent four-dimensional-based IMRT-SIBbased neoadjuvant chemoradiation *** the concurrent chemoradiation therapy,radiation therapy was through IMRT-SIB delivered in 28 consecutive daily fractions with total radiation doses of 56 Gy to tumor and 5040 Gy dose-painted to clinical tumor volume,with a regimen at the discretion of the treating medical *** was followed by surgical tumor *** analyzed pathological completion response(p CR) rates its relationship with overall survival and ***:Seventeen patients underwent dose escalation with the IMRT-SIB protocol between 2007 and 2014 and their records were available for *** the IMRT-SIB-treated patients,the toxicity appeared mild,the most common side effects were grade 1-3 esophagitis(46%) and pneumonitis(11.7%).There were no cardiac *** Ro resection rate was 94%(n = 16),the p CR rate was 47%(n = 8),and the postoperative morbidity was *** was one mediastinal failure found,one patient had local failure at the anastomosis site,and the majority of failures were distant in the lung or *** 3-year diseasefree survival and overall survival rates were 41%(n = 7) and 53%(n = 9),***:The dose escalation through IMRT-SIB in the chemoradiation regimen seems responsible for down-staging the distal esophageal with well-tolerated complications.