Differences in displacement of the proximal and distal ends of mid-upper thoracic esophageal squamous cell carcinoma

Qiu,Guoqin; Wen,Dengshun; Du,Xianghui; Sheng,Liming; Zhou,Xia; Ji,Yongling; Bao,Wuan; Zhang,Danhong; Cheng,Lei

doi:10.3892/mco.2016.899

Differences in displacement of the proximal and distal ends of mid-upper thoracic esophageal squamous cell carcinoma

Authors:
- Guoqin Qiu
- Dengshun Wen
- Xianghui Du
- Liming Sheng
- Xia Zhou
- Yongling Ji
- Wuan Bao
- Danhong Zhang
- Lei Cheng
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Affiliations: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
Published online on: May 11, 2016 https://doi.org/10.3892/mco.2016.899
Pages: 143-147

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Abstract

In the present study, clips were used as markers to evaluate displacement differences between proximal and distal ends of esophageal tumors and to test whether their internal target volume (ITV) margins should be determined separately. A total of 23 patients with mid‑upper thoracic esophageal squamous‑cell carcinoma, a tumor length of ≤8 cm and an esophageal lumen suitable for endoscopic ultrasonography were recruited for the present study. Clips were implanted endoscopically at the proximal and distal ends of the esophageal tumor (upper and lower clips). In a further exploratory study on 16 of the patients, a third clip was placed at the distal esophagus 2 cm above the gastro-esophageal junction (GEJ) (cardiac clip). The clips were contoured for all 10 phases of the four-dimensional computed tomography and the maximum displacements of the clip centroids among different breathing phases in left‑right (LR), superior-inferior (SI) and anterior‑posterior (AP) directions were marked as x, y and z, respectively. The ITV margins that covered 95% of the LR, SI and AP motion were 2.89, 5.00 and 2.36 mm, respectively. Axial displacement (y) was greater than radial displacement (x, z; P<0.05). It was also revealed that LR(x), SI(y) and AP(z) displacement of cardiac clips was greater than that of upper or lower clips (P<0.05). Differences in the axial and radial displacement of the upper and lower clips indicated that axial and radial ITV margins should be determined separately. However, further study is required on patients in whom the distal tumor end is located in proximity to the GEJ.

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1	Minsky BD, Pajak TF, Ginsberg RJ, et al: INT 0123 (Radiation Therapy Oncology Group 94–05) phase III trial of combined-modality therapy for esophageal cancer: High-dose versus standard-dose radiation therapy. J Clin Oncol. 20:1167–1174. 2002. View Article : Google Scholar : PubMed/NCBI
2	van Hagen P, Hulshof MC, van Lanschot JJ, et al: Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 366:2074–2084. 2012. View Article : Google Scholar : PubMed/NCBI
3	International Commission on Radiation Units and Measurements. ICRU report 62: Prescribing, recording and reporting photon beam therapy (supplement to ICRU report 50) (Washington, DC). ICRU. 1999.
4	Admiraal MA, Schuring D and Hurkmans CW: Dose calculations accounting for breathing motion in stereotactic lung radiotherapy based on 4D-CT and the internal target volume. Radiother Oncol. 86:55–60. 2008. View Article : Google Scholar : PubMed/NCBI
5	Yakoumakis N, Winey B, Killoran J, Mayo C, Niedermayr T, Panayiotakis G, Lingos T and Court L: Using four-dimensional computed tomography images to optimize the internal target volume when using volume-modulated arc therapy to treat moving targets. J Appl Clin Med Phys. 13:38502012.PubMed/NCBI
6	Zhao KL, Liao Z, Bucci MK, Komaki R, Cox JD, Yu ZH, Zhang L, Mohan R and Dong L: Evaluation of respiratory-induced target motion for esophageal tumors at the gastroesophageal junction. Radiother Oncol. 84:283–289. 2007. View Article : Google Scholar : PubMed/NCBI
7	Yaremko BP, Guerrero TM, McAleer MF, Bucci MK, Noyola-Martinez J, Nguyen LT, Balter PA, Guerra R, Komaki R and Liao Z: Determination of respiratory motion for distal esophagus cancer using four-dimensional computed tomography. Int J Radiat Oncol Biol Phys. 70:145–153. 2008. View Article : Google Scholar : PubMed/NCBI
8	Pan CC, Kashani R, Hayman JA, et al: Intra- and inter-fraction esophagus motion in 3D-conformal radiotherapy: Implications for ICRU 62 definitions of internal target volume and planning organ at risk volume. Int J Radiat Oncol Biol Phys. 60(Suppl): S580–S581. 2004. View Article : Google Scholar
9	Dieleman EM, Senan S, Vincent A, Lagerwaard FJ, Slotman BJ and van Sörnsen de Koste JR: Four-dimensional computed tomographic analysis of esophageal mobility during normal respiration. Int J Radiat Oncol Biol Phys. 67:775–780. 2007. View Article : Google Scholar : PubMed/NCBI
10	Hashimoto T, Shirato H, Kato M, Yamazaki K, Kurauchi N, Morikawa T, Shimizu S, Ahn YC, Akine Y and Miyasaka K: Real-time monitoring of a digestive tract marker to reduce adverse effects of moving organs at risk (OAR) in radiotherapy for thoracic and abdominal tumors. Int J Radiat Oncol Biol Phys. 61:1559–1564. 2005. View Article : Google Scholar : PubMed/NCBI
11	Ding Y, Li J, Wang W, Wang S, Wang J, Ma Z, Shao Q and Xu M: A comparative study on the volume and localization of the internal gross target volume defined using the seroma and surgical clips based on 4DCT scan for external-beam partial breast irradiation after breast conserving surgery. Radiat Oncol. 9:762014. View Article : Google Scholar : PubMed/NCBI
12	Roman NO, Shepherd W, Mukhopadhyay N, Hugo GD and Weiss E: Interfractional positional variability of fiducial markers and primary tumors in locally advanced non-small-cell lung cancer during audiovisual biofeedback radiotherapy. Int J Radiat Oncol Biol Phys. 83:1566–1572. 2012. View Article : Google Scholar : PubMed/NCBI
13	Ueki N, Matsuo Y, Nakamura M, Mukumoto N, Iizuka Y, Miyabe Y, Sawada A, Mizowaki T, Kokubo M and Hiraoka M: Intra- and interfractional variations in geometric arrangement between lung tumours and implanted markers. Radiother Oncol. 110:523–528. 2014. View Article : Google Scholar : PubMed/NCBI
14	Qiu GQ, Du XH, Yu JP, Zheng YD, Luo HJ, Xu YP, Chen JX, Sun XJ, Ji YL and Tao YL: The value of endoscopic ultrasonography in defining longitudinal gross target volumes for esophageal squamous carcinoma. Surg Laparosc Endosc Percutan Tech. 22:424–428. 2012. View Article : Google Scholar : PubMed/NCBI
15	Patel AA, Wolfgang JA, Niemierko A, Hong TS, Yock T and Choi NC: Implications of respiratory motion as measured by four-dimensional computed tomography for radiation treatment planning of esophageal cancer. Int J Radiat Oncol Biol Phys. 74:290–296. 2009. View Article : Google Scholar : PubMed/NCBI
16	Lorchel F, Dumas JL, Noël A, Wolf D, Bosset JF and Aletti P: Esophageal cancer: Determination of internal target volume for conformal radiotherapy. Radiother Oncol. 80:327–332. 2006. View Article : Google Scholar : PubMed/NCBI
17	Yamashita H, Kida S, Sakumi A, Haga A, Ito S, Onoe T, Okuma K, Ino K, Akahane M, Ohtomo K and Nakagawa K: Four-dimensional measurement of the displacement of internal fiducial markers during 320-multislice computed tomography scanning of thoracic esophageal cancer. Int J Radiat Oncol Biol Phys. 79:588–595. 2011. View Article : Google Scholar : PubMed/NCBI
18	Greene FL, Page DL, Fleming ID, et al: AJCC Cancer Staging Manual (6th). Springer-Verlag. New York: 2002. View Article : Google Scholar
19	Yamashita H, Okuma K, Tada K, Shiraishi K, Takahashi W, Shibata-Mobayashi S, Sakumi A, Saotome N, Haga A, Onoe T, et al: Four-dimensional measurement of the displacement of internal fiducial and skin markers during 320-multislice computed tomography scanning of breast cancer. Int J Radiat Oncol Biol Phys. 84:331–335. 2012. View Article : Google Scholar : PubMed/NCBI