Esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer: Frequency and prediction

Kazushige Atsumi, Yoshiyuki Shioyama, Hidetaka Arimura, Kotaro Terashima, Takaomi Matsuki, Ohga Saiji, Tadamasa Yoshitake, Takeshi Nonoshita, Daisuke Tsurumaru, Kayoko Ohnishi, Kaori Asai, Keiji Matsumoto, Katsumasa Nakamura, Hiroshi Honda

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: To determine clinical factors for predicting the frequency and severity of esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer. Methods and Materials: The study group consisted of 109 patients with esophageal cancer of T1-4 and Stage I-III who were treated with definitive radiotherapy and achieved a complete response of their primary lesion at Kyushu University Hospital between January 1998 and December 2007. Esophageal stenosis was evaluated using esophagographic images within 3 months after completion of radiotherapy. We investigated the correlation between esophageal stenosis after radiotherapy and each of the clinical factors with regard to tumors and therapy. For validation of the correlative factors for esophageal stenosis, an artificial neural network was used to predict the esophageal stenotic ratio. Results: Esophageal stenosis tended to be more severe and more frequent in T3-4 cases than in T1-2 cases. Esophageal stenosis in cases with full circumference involvement tended to be more severe and more frequent than that in cases without full circumference involvement. Increases in wall thickness tended to be associated with increases in esophageal stenosis severity and frequency. In the multivariate analysis, T stage, extent of involved circumference, and wall thickness of the tumor region were significantly correlated to esophageal stenosis (p = 0.031, p < 0.0001, and p = 0.0011, respectively). The esophageal stenotic ratio predicted by the artificial neural network, which learned these three factors, was significantly correlated to the actual observed stenotic ratio, with a correlation coefficient of 0.864 (p < 0.001). Conclusion: Our study suggested that T stage, extent of involved circumference, and esophageal wall thickness of the tumor region were useful to predict the frequency and severity of esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer.

Original languageEnglish
Pages (from-to)1973-1980
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume82
Issue number5
DOIs
Publication statusPublished - Apr 1 2012

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Esophageal Stenosis
Esophageal Neoplasms
circumferences
radiation therapy
Radiotherapy
tumors
cancer
predictions
Neoplasms
correlation coefficients
lesions
therapy
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer : Frequency and prediction. / Atsumi, Kazushige; Shioyama, Yoshiyuki; Arimura, Hidetaka; Terashima, Kotaro; Matsuki, Takaomi; Saiji, Ohga; Yoshitake, Tadamasa; Nonoshita, Takeshi; Tsurumaru, Daisuke; Ohnishi, Kayoko; Asai, Kaori; Matsumoto, Keiji; Nakamura, Katsumasa; Honda, Hiroshi.

In: International Journal of Radiation Oncology Biology Physics, Vol. 82, No. 5, 01.04.2012, p. 1973-1980.

Research output: Contribution to journalArticle

Atsumi, Kazushige ; Shioyama, Yoshiyuki ; Arimura, Hidetaka ; Terashima, Kotaro ; Matsuki, Takaomi ; Saiji, Ohga ; Yoshitake, Tadamasa ; Nonoshita, Takeshi ; Tsurumaru, Daisuke ; Ohnishi, Kayoko ; Asai, Kaori ; Matsumoto, Keiji ; Nakamura, Katsumasa ; Honda, Hiroshi. / Esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer : Frequency and prediction. In: International Journal of Radiation Oncology Biology Physics. 2012 ; Vol. 82, No. 5. pp. 1973-1980.
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AU - Atsumi, Kazushige

AU - Shioyama, Yoshiyuki

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AU - Terashima, Kotaro

AU - Matsuki, Takaomi

AU - Saiji, Ohga

AU - Yoshitake, Tadamasa

AU - Nonoshita, Takeshi

AU - Tsurumaru, Daisuke

AU - Ohnishi, Kayoko

AU - Asai, Kaori

AU - Matsumoto, Keiji

AU - Nakamura, Katsumasa

AU - Honda, Hiroshi

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N2 - Purpose: To determine clinical factors for predicting the frequency and severity of esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer. Methods and Materials: The study group consisted of 109 patients with esophageal cancer of T1-4 and Stage I-III who were treated with definitive radiotherapy and achieved a complete response of their primary lesion at Kyushu University Hospital between January 1998 and December 2007. Esophageal stenosis was evaluated using esophagographic images within 3 months after completion of radiotherapy. We investigated the correlation between esophageal stenosis after radiotherapy and each of the clinical factors with regard to tumors and therapy. For validation of the correlative factors for esophageal stenosis, an artificial neural network was used to predict the esophageal stenotic ratio. Results: Esophageal stenosis tended to be more severe and more frequent in T3-4 cases than in T1-2 cases. Esophageal stenosis in cases with full circumference involvement tended to be more severe and more frequent than that in cases without full circumference involvement. Increases in wall thickness tended to be associated with increases in esophageal stenosis severity and frequency. In the multivariate analysis, T stage, extent of involved circumference, and wall thickness of the tumor region were significantly correlated to esophageal stenosis (p = 0.031, p < 0.0001, and p = 0.0011, respectively). The esophageal stenotic ratio predicted by the artificial neural network, which learned these three factors, was significantly correlated to the actual observed stenotic ratio, with a correlation coefficient of 0.864 (p < 0.001). Conclusion: Our study suggested that T stage, extent of involved circumference, and esophageal wall thickness of the tumor region were useful to predict the frequency and severity of esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer.

AB - Purpose: To determine clinical factors for predicting the frequency and severity of esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer. Methods and Materials: The study group consisted of 109 patients with esophageal cancer of T1-4 and Stage I-III who were treated with definitive radiotherapy and achieved a complete response of their primary lesion at Kyushu University Hospital between January 1998 and December 2007. Esophageal stenosis was evaluated using esophagographic images within 3 months after completion of radiotherapy. We investigated the correlation between esophageal stenosis after radiotherapy and each of the clinical factors with regard to tumors and therapy. For validation of the correlative factors for esophageal stenosis, an artificial neural network was used to predict the esophageal stenotic ratio. Results: Esophageal stenosis tended to be more severe and more frequent in T3-4 cases than in T1-2 cases. Esophageal stenosis in cases with full circumference involvement tended to be more severe and more frequent than that in cases without full circumference involvement. Increases in wall thickness tended to be associated with increases in esophageal stenosis severity and frequency. In the multivariate analysis, T stage, extent of involved circumference, and wall thickness of the tumor region were significantly correlated to esophageal stenosis (p = 0.031, p < 0.0001, and p = 0.0011, respectively). The esophageal stenotic ratio predicted by the artificial neural network, which learned these three factors, was significantly correlated to the actual observed stenotic ratio, with a correlation coefficient of 0.864 (p < 0.001). Conclusion: Our study suggested that T stage, extent of involved circumference, and esophageal wall thickness of the tumor region were useful to predict the frequency and severity of esophageal stenosis associated with tumor regression in radiotherapy for esophageal cancer.

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