Impact of Gastric Filling on Radiation Dose Delivered to Gastroesophageal Junction Tumors

Journal Article · Sat May 01 00:00:00 EDT 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.08.026· OSTI ID:21372272

Bouchard, Myriam ^[1]; McAleer, Mary Frances ^[2]; Starkschall, George ^[1]

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1. Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
2. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

Purpose: This study examined the impact of gastric filling variation on target coverage of gastroesophageal junction (GEJ) tumors in three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), or IMRT with simultaneous integrated boost (IMRT-SIB) plans. Materials and Methods: Eight patients previously receiving radiation therapy for esophageal cancer had computed tomography (CT) datasets acquired with full stomach (FS) and empty stomach (ES). We generated treatment plans for 3DCRT, IMRT, or IMRT-SIB for each patient on the ES-CT and on the FS-CT datasets. The 3DCRT and IMRT plans were planned to 50.4 Gy to the clinical target volume (CTV), and the same for IMRT-SIB plus 63.0 Gy to the gross tumor volume (GTV). Target coverage was evaluated using dose-volume histogram data for patient treatments simulated with ES-CT sets, assuming treatment on an FS for the entire course, and vice versa. Results: FS volumes were a mean of 3.3 (range, 1.7-7.5) times greater than ES volumes. The volume of the GTV receiving >=50.4 Gy (V{sub 50.4Gy}) was 100% in all situations. The planning GTV V{sub 63Gy} became suboptimal when gastric filling varied, regardless of whether simulation was done on the ES-CT or the FS-CT set. Conclusions: Stomach filling has a negligible impact on prescribed dose delivered to the GEJ GTV, using either 3DCRT or IMRT planning. Thus, local relapses are not likely to be related to variations in gastric filling. Dose escalation for GEJ tumors with IMRT-SIB may require gastric filling monitoring.

• OSTI ID: 21372272
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 77, Issue 1; Other Information: DOI: 10.1016/j.ijrobp.2009.08.026; PII: S0360-3016(09)02971-X; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
COMPUTERIZED TOMOGRAPHY
ESOPHAGUS
NEOPLASMS
PLANNING
RADIATION DOSES
RADIOTHERAPY
STOMACH
THREE-DIMENSIONAL CALCULATIONS
BODY
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
DOSES
GASTROINTESTINAL TRACT
MEDICINE
NUCLEAR MEDICINE
ORGANS
RADIOLOGY
THERAPY
TOMOGRAPHY