ArticleTechnology in cancer research & treatment
Impact of Esophageal Motion on Dosimetry and Toxicity With Thoracic Radiation Therapy.
Article in Technology in cancer research & treatment. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 9 citations in OpenAlex.
- Dosimetric impact of esophageal motion in esophagus-sparing radiotherapy of spinal metastases.Acta oncologica (Stockholm, Sweden) · 2025Article
- Account for the Full Extent of Esophagus Motion in Radiation Therapy Planning: A Preliminary Study of the IRV of the Esophagus.Frontiers in oncology · 2021Article
- Quantification of accumulated dose and associated anatomical changes of esophagus using weekly Magnetic Resonance Imaging acquired during radiotherapy of locally advanced lung cancer.Physics and imaging in radiation oncology · 2020Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo investigate the impact of intra- and inter-fractional esophageal motion on dosimetry and observed toxicity in a phase I dose escalation study of accelerated radiotherapy with concurrent chemotherapy for locally advanced lung cancer. METHODS AND MATERIALS: Patients underwent computed tomography imaging for radiotherapy treatment planning (CT1 and 4DCT1) and at 2 weeks (CT2 and 4DCT2) and 5 weeks (CT3 and 4DCT3) after initiating treatment. Each computed tomography scan consisted of 10-phase 4DCTs in addition to a static free-breathing or breath-hold computed tomography. The esophagus was independently contoured on all computed tomographies and 4DCTs. Both CT2 and CT3 were rigidly registered with CT1 and doses were recalculated using the original intensity-modulated radiation therapy plan based on CT1 to assess the impact of interfractional motion on esophageal dosimetry. Similarly, 4DCT1 data sets were rigidly registered with CT1 to assess the impact of intrafractional motion. The motion was characterized based on the statistical analysis of slice-by-slice center shifts (after registration) for the upper, middle, and lower esophageal regions, respectively. For the dosimetric analysis, the following quantities were calculated and assessed for correlation with toxicity grade: the percent volumes of esophagus that received at least 20 Gy (V20) and 60 Gy (V60), maximum esophageal dose, equivalent uniform dose, and normal tissue complication probability.
resultsThe interfractional center shifts were 4.4 ± 1.7 mm, 5.5 ± 2.0 mm and 4.9 ± 2.1 mm for the upper, middle, and lower esophageal regions, respectively, while the intrafractional center shifts were 0.6 ± 0.4 mm, 0.7 ± 0.7 mm, and 0.9 ± 0.7 mm, respectively. The mean V60 (and corresponding normal tissue complication probability) values estimated from the interfractional motion analysis were 7.8% (10%), 4.6% (7.5%), 7.5% (8.6%), and 31% (26%) for grade 0, grade 1, grade 2, and grade 3 toxicities, respectively.
conclusionsInterfractional esophageal motion is significantly larger than intrafractional motion. The mean values of V60 and corresponding normal tissue complication probability, incorporating interfractional esophageal motion, correlated positively with esophageal toxicity grade.
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