Evidence map›Paper›PMID 30237946›Full record

ArticleCureus2018

What Is the Optimal Radiation Technique for Esophageal Cancer? A Dosimetric Comparison of Four Techniques.

Ziad Simon Fawaz, Suzanne Kazandjian, James M Tsui, Dr Slobodan Devic, Magali Lecavalier-Barsoum, Te Vuong, Sara Elakshar, Aurelie Garant, Isabelle Lavoie, Tamin M Niazi

Open access · diamondAbstract read
In one paragraph

Article in Cureus, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Ziad Simon FawazRadiation Oncology, McGill University Health Center, Montreal, CAN.
Suzanne KazandjianRadiation Oncology, McGill University/Sir Mortimer B. Davis Jewish General Hospital, Montreal, CAN.
James M TsuiOncology/Radiation Oncology, Cedars Cancer Centre/McGill University Health Centre, Montreal, CAN.
Dr Slobodan DevicRadiation Oncology, McGill University/Sir Mortimer B. Davis Jewish General Hospital, Montreal, CAN.
Magali Lecavalier-BarsoumRadiation Oncology, McGill University/Sir Mortimer B. Davis Jewish General Hospital, Montreal, CAN.
Te VuongRadiation Oncology, McGill University/Sir Mortimer B. Davis Jewish General Hospital, Montreal, CAN.
Sara ElaksharRadiation Oncology, McGill University/Sir Mortimer B. Davis Jewish General Hospital, Montreal, CAN.
Aurelie GarantRadiation Oncology, McGill University Health Centre, Montreal, CAN.
Isabelle LavoieRadiation Oncology, McGill University/Jewish General Hospital, Montreal, CAN.
Tamin M NiaziOncology, McGill University Health Centre/Jewish General Hospital, Montreal , CAN.
Jewish General Hospital · CAMcGill University · CAMcGill University Health Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Esophageal cancer treatment requires large radiation fields due to the deep location of the esophagus in the mediastinum and the high incidence of radial spread. There is no optimal radiation technique to ensure appropriate target coverage and minimal dose to all normal structures. Methods Fifteen consecutive cases of locally advanced esophageal cancer treated with radical chemoradiation (CRT) were analyzed. The total prescribed dose was 50.4 Gy in 28 fractions. A total of 60 plans were generated for analysis, including four different methods for each case. Method 1 consisted of a four-field conformal technique; method 2 was a two-plan technique (antero-posterior (AP), postero-anterior (PA), two posterior oblique fields (RPO and LPO)); method 3 was a three-field conformal technique (AP, LPO, RPO); and method 4 was a volumetric modulated arc radiotherapy (VMAT) technique. Dose ratios were calculated using the minimum, maximum, mean, and median doses of methods 2-4 over the dose of method 1. Ratios for the planning target volume (PTV) and to surrounding organs were analyzed. Results The mean PTV dose ratio ranged from 0.994 to 1.048 (SD = 0.01) representing an adequate target coverage for all techniques based on an analysis of variance (ANOVA). For the lungs, method 2 had the lowest lung V20 with a ratio of 0.861 (SD = 0.12), whereas method 3 had the highest with 1.644 (SD = 0.14). For the heart, method 3 had the lowest heart V40 with a mean dose ratio of 0.807 (SD = 0.09), whereas method 2 had the highest with 1.160 (SD = 0.11). For the liver, method 2 had the lowest V30 with a mean ratio of 0.857 (SD = 0.1) whereas method 4 had the highest with 1.672 (SD = 0.48). For the spinal cord, method 3 had the lowest mean dose ratio of 0.559 (SD = 0.09) whereas method 2 had the highest with 1.094 (SD = 0.04). Conclusion The four radiation techniques for esophageal cancer treatment were appropriate for target coverage. Method 2 had the most organ-sparing effect for the lungs and liver, and method 3 for the heart and spinal cord. VMAT did not add any significant sparing. A case-by-case decision should be made based on the patient's comorbidities.

Indexed as

cancerconformaldosimetricesophagealimrttechniquevmat

Identifiers

PMID30237946
PMCPMC6141055
OpenAlexW2883137035

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.