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ORIGINAL ARTICLE
Year : 2020  |  Volume : 3  |  Issue : 1  |  Page : 17-24

Dosimetric assessment of heart in cancer esophagus patients treated by chemoradiation: A retrospective analysis


Department of Radiation Oncology, Shri Ram Murti Smarak Institute of Medical Sciences, Nainital Rd, Bhoji Pura, Bareilly, Uttar Pradesh, India

Correspondence Address:
Dr. Piyush Kumar
Shri Ram Murti Smarak Institute of Medical Sciences, Nainital Rd, Bhoji Pura, Bareilly, Uttar Pradesh,
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jco.jco_6_20

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Context: Radiation-induced cardiac events have not gained much concern in esophageal malignancies. There are several serious cardiac events, which may impact the overall survival rates. Aims: This study was designed to compare the dosimetric parameters of heart in patients with carcinoma esophagus planned by intensity-modulated radiotherapy (IMRT) and 3Dimensional conformal radiotherapy (3DCRT) technique. Materials and Methods: Twenty-two patients with carcinoma esophagus who were treated by the IMRT technique to a dose of 50.4 Gy were retrospectively selected for the study and corresponding virtual 3DCRT plans were generated for study purpose (total = 44 plans). The dosimetric parameters of the resulting plans were compared for planning target volume (PTV) and organs at risk: heart, left ventricle, left anterior descending artery, and lungs. Statistical Analysis Used: Paired t test. Results: The dosimetric parameters of PTV were comparable for D50, Dmean; however, a significant improvement was observed in D95 (P = 0.0005), D90 (P = 0.003), homogeneity index, and conformity index (P < 0.0001 each) with IMRT. A significant reduction in the various dose volumes of the heart (V20, V25, V30, V40, D33, D67, D100), left anterior descending artery (V30, V40), and left ventricle (V30, V40) along with mean dose was seen. The lung dose was nearly comparable in terms of Dmean and V20. Conclusion: IMRT has a better dose homogeneity and conformity compared to 3DCRT. Better cardiac sparing may translate into a decreased incidence of long-term radiation-induced cardiac complications.


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