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Residual Tumor After Neoadjuvant Chemoradiation Outside the Radiation Therapy Target Volume
- Source :
- International Journal of Radiation Oncology Biology Physics, 88(4), 845-852. ELSEVIER SCIENCE INC
- Publication Year :
- 2014
- Publisher :
- ELSEVIER SCIENCE INC, 2014.
-
Abstract
- Purpose/Objective(s): The aim of this study was to analyze the accuracy of gross tumor volume (GTV) delineation and clinical target volume (CTV) margins for neoadjuvant chemoradiation therapy (neo-CRT) in esophageal carcinoma at pathologic examination and to determine the impact on survival.Methods and Materials: The study population consisted of 63 esophageal cancer patients treated with neo-CRT. GTV and CTV borders were demarcated in situ during surgery on the esophagus, using anatomical reference points to provide accurate information regarding tumor location at pathologic evaluation. To identify prognostic factors for disease-free survival (DFS) and overall survival (OS), a Cox regression analysis was performed.Results: After resection, macroscopic residual tumor was found outside the GTV in 7 patients (11%). Microscopic residual tumor was located outside the CTV in 9 patients (14%). The median follow-up was 15.6 months. With multivariate analysis, only microscopic tumor outside the CTV (hazard ratio [HR], 4.96; 95% confidence interval [CI], 1.03-15.36), and perineural growth (HR, 5.77; 95% CI, 1.27-26.13) were identified as independent prognostic factors for OS. The 1-year OS was 20% for patients with tumor outside the CTV and 86% for those without (PConclusions: Microscopic tumor outside the CTV is associated with markedly worse OS after neo-CRT. This may either stress the importance of accurate tumor delineation or reflect aggressive tumor behavior requiring new adjuvant treatment modalities. (C) 2014 Elsevier Inc.
- Subjects :
- Oncology
Male
Cancer Research
Neoplasm, Residual
Esophageal Neoplasms
medicine.medical_treatment
Radiotherapy Planning
Carboplatin
Computer-Assisted
Antineoplastic Combined Chemotherapy Protocols
80 and over
Prospective Studies
Prospective cohort study
Adjuvant
Aged, 80 and over
Radiation
Hazard ratio
Esophageal cancer
Middle Aged
Prognosis
Tumor Burden
medicine.anatomical_structure
Chemotherapy, Adjuvant
Residual
Carcinoma, Squamous Cell
Adenocarcinoma
Regression Analysis
Female
Radiology
Anatomic Landmarks
Adult
medicine.medical_specialty
Paclitaxel
Disease-Free Survival
Internal medicine
medicine
Carcinoma
Chemotherapy
Humans
Radiology, Nuclear Medicine and imaging
Esophagus
Aged
Neoplasm Staging
business.industry
Proportional hazards model
Radiotherapy Planning, Computer-Assisted
medicine.disease
Radiation therapy
Squamous Cell
Neoplasm
business
Subjects
Details
- Language :
- English
- ISSN :
- 1879355X and 03603016
- Volume :
- 88
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- International Journal of Radiation Oncology Biology Physics
- Accession number :
- edsair.doi.dedup.....9f3061a1bd7d4d3ffa5ff05741b125fd