PMID- 23835387
OWN - NLM
STAT- MEDLINE
DCOM- 20131210
LR  - 20211021
IS  - 1526-9914 (Electronic)
IS  - 1526-9914 (Linking)
VI  - 14
IP  - 4
DP  - 2013 Jul 8
TI  - Self-expanding stent effects on radiation dosimetry in esophageal cancer.
PG  - 4218
LID - 10.1120/jacmp.v14i4.4218 [doi]
AB  - It is the purpose of this study to evaluate how self-expanding stents (SESs) 
      affect esophageal cancer radiation planning target volumes (PTVs) and dose 
      delivered to surrounding organs at risk (OARs). Ten patients were evaluated, for 
      whom a SES was placed before radiation. A computed tomography (CT) scan obtained 
      before stent placement was fused to the post-stent CT simulation scan. Three 
      methods were used to represent pre-stent PTVs: 1) image fusion (IF), 2) volume 
      approximation (VA), and 3) diameter approximation (DA). PTVs and OARs were 
      contoured per RTOG 1010 protocol using Eclipse Treatment Planning software. 
      Post-stent dosimetry for each patient was compared to approximated pre-stent 
      dosimetry. For each of the three pre-stent approximations (IF, VA, and DA), the 
      mean lung and liver doses and the estimated percentages of lung volumes receiving 
      5 Gy, 10 Gy, 20 Gy, and 30 Gy, and heart volumes receiving 40 Gy were 
      significantly lower (p-values < 0.02) than those estimated in the post-stent 
      treatment plans. The lung V5, lung V10, and heart V40 constraints were achieved 
      more often using our pre-stent approximations. Esophageal SES placement increases 
      the dose delivered to the lungs, heart, and liver. This may have clinical 
      importance, especially when the dose-volume constraints are near the recommended 
      thresholds, as was the case for lung V5, lung V10, and heart V40. While stents 
      have established benefits for treating patients with significant dysphagia, 
      physicians considering stent placement and radiation therapy must realize the 
      effects stents can have on the dosimetry.
FAU - Francis, Samual R
AU  - Francis SR
AD  - Department of Radiation Oncology, University of Utah, Huntsman Cancer Hospital, 
      Salt Lake City, Utah 84112, USA.
FAU - Anker, Christopher J
AU  - Anker CJ
FAU - Wang, Brian
AU  - Wang B
FAU - Williams, Greg V
AU  - Williams GV
FAU - Cox, Kristen
AU  - Cox K
FAU - Adler, Douglas G
AU  - Adler DG
FAU - Shrieve, Dennis C
AU  - Shrieve DC
FAU - Salter, Bill J
AU  - Salter BJ
LA  - eng
PT  - Journal Article
DEP - 20130708
PL  - United States
TA  - J Appl Clin Med Phys
JT  - Journal of applied clinical medical physics
JID - 101089176
SB  - IM
MH  - Esophageal Neoplasms/diagnostic imaging/*radiotherapy/*surgery
MH  - Humans
MH  - Imaging, Three-Dimensional
MH  - Radiometry/*methods/statistics & numerical data
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/statistics & numerical data
MH  - *Stents
MH  - Tomography, X-Ray Computed
PMC - PMC5714531
EDAT- 2013/07/10 06:00
MHDA- 2013/12/16 06:00
PMCR- 2013/07/08
CRDT- 2013/07/10 06:00
PHST- 2012/09/18 00:00 [received]
PHST- 2013/02/13 00:00 [accepted]
PHST- 2013/02/18 00:00 [revised]
PHST- 2013/07/10 06:00 [entrez]
PHST- 2013/07/10 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
PHST- 2013/07/08 00:00 [pmc-release]
AID - ACM20121 [pii]
AID - 10.1120/jacmp.v14i4.4218 [doi]
PST - epublish
SO  - J Appl Clin Med Phys. 2013 Jul 8;14(4):4218. doi: 10.1120/jacmp.v14i4.4218.