Erschienen in:
01.12.2018 | Original Paper
Volumetric modulated arc therapy (VMAT) in the treatment of esophageal cancer patients
verfasst von:
Stefania Martini, Francesca Arcadipane, Paolo Strignano, Rosella Spadi, Viviana Contu, Christian Fiandra, Riccardo Ragona, Giorgia Catalano, Maria Antonietta Satolli, Michele Camandona, Renato Romagnoli, Umberto Ricardi, Pierfrancesco Franco
Erschienen in:
Medical Oncology
|
Ausgabe 12/2018
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Abstract
The aim of the study is to evaluate feasibility, safety, toxicity profile, and dosimetric results of volumetric modulated arc therapy (VMAT) to deliver definitive or pre-operative radiation in locally advanced esophageal cancer patients. A total of 68 patients were treated with VMAT between March 2014 and March 2018 (44% vs 56% for definitive and neoadjuvant settings, respectively). Dose prescription differed depending on the clinical scenario (54–60 Gy in 30 fractions for definitive treatments; 41.4/45 Gy in 23–25 fractions in the pre-operative setting). Most of the patients were given concurrent chemotherapy. Two coplanar and one non-coplanar arcs were employed for VMAT delivery. Treatment was generally well tolerated. Acute toxicity was generally mild. In patients treated with definitive intent, ≥ G3 toxicities were observed for esophagitis (30%), anorexia (26.7%), fatigue (26.7%), nausea (6.7%), and vomiting (3.3%). In patients treated within a neoadjuvant approach, ≥ G3 anorexia (21%), esophagitis (15.8%), fatigue (13.3%), nausea (5.3%), and vomiting (2.6%) were observed. Dosimetric results were consistent in term of both target coverage and normal tissue sparing. In conclusion, VMAT proved to be a feasible, safe, and effective strategy to deliver definitive or pre-operative radiation in locally advanced esophageal cancer patients.