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@article{1834653,
author = {Slávik, Marek and Burkoň, Petr and Selingerová, Iveta and Krupa, Pavel and Kazda, Tomáš and Stankova, Jaroslava and Nikl, Tomas and Hejnová, Renata and Řehák, Zdeněk and Ošmera, Pavel and Procházka, Tomáš and Dvorakova, Eva and Pospíšil, Petr and Grell, Peter and Šlampa, Pavel and Obermannová, Radka},
article_location = {Basel},
article_number = {12},
doi = {http://dx.doi.org/10.3390/medicina57121334},
keywords = {gastroesophageal junction cancer; PET; CT; radiotherapy; neoadjuvant chemoradiotherapy},
language = {eng},
issn = {1010-660X},
journal = {Medicina-Lithuania},
title = {Preoperative Chemoradiotherapy for Gastroesophageal Junction Adenocarcinoma Modified by PET/CT: Results of Virtual Planning Study},
url = {https://www.mdpi.com/1648-9144/57/12/1334},
volume = {57},
year = {2021}
}
TY - JOUR
ID - 1834653
AU - Slávik, Marek - Burkoň, Petr - Selingerová, Iveta - Krupa, Pavel - Kazda, Tomáš - Stankova, Jaroslava - Nikl, Tomas - Hejnová, Renata - Řehák, Zdeněk - Ošmera, Pavel - Procházka, Tomáš - Dvorakova, Eva - Pospíšil, Petr - Grell, Peter - Šlampa, Pavel - Obermannová, Radka
PY - 2021
TI - Preoperative Chemoradiotherapy for Gastroesophageal Junction Adenocarcinoma Modified by PET/CT: Results of Virtual Planning Study
JF - Medicina-Lithuania
VL - 57
IS - 12
SP - 1-12
EP - 1-12
PB - MDPI
SN - 1010660X
KW - gastroesophageal junction cancer
KW - PET
KW - CT
KW - radiotherapy
KW - neoadjuvant chemoradiotherapy
UR - https://www.mdpi.com/1648-9144/57/12/1334
N2 - Background and Objectives: The treatment of gastroesophageal junction (GEJ) adenocarcinoma consists of either perioperative chemotherapy or preoperative chemoradiotherapy. Radiotherapy (RT) in the neoadjuvant setting is associated with a higher probability of resections with negative margins (R0) and better tumor regression rate, which might be enhanced by incrementing RT dose with potential impact on treatment results. This virtual planning study demonstrates the feasibility of increasing the dose to GEJ tumor and involved nodes using PET/CT imaging. Materials and Methods: 16 patients from the chemoradiotherapy arm of the phase II GastroPET study were treated by a prescribed dose of 45.0 Gray (Gy) in 25 fractions. PET/CT was performed before treatment. The prescribed dose was virtually boosted on PET/CT-positive areas to 54.0 Gy by 9 Gy in 5 fractions. Dose-volume histograms (DVH) were compared, and normal tissue complication (NTCP) modeling was performed for both dose schedules. Results: DVHs were exceeded in mean heart dose in one case for 45.0 Gy and two cases for 54.0 Gy, peritoneal space volume criterion V-45Gy < 195 ccm in three cases for 54.0 Gy and V-15Gy < 825 ccm in one case for both dose schedules. The left lung volume of 25 Gy isodose exceeded 10% in most cases for both schedules. The NTCP values for the heart, spine, liver, kidneys and intestines were zero for both schemes. An increase in NTCP value was for lungs (median 3.15% vs. 4.05% for 25 x 1.8 Gy and 25 + 5 x 1.8 Gy, respectively, p = 0.013) and peritoneal space (median values for 25 x 1.8 Gy and 25 + 5 x 1.8 Gy were 3.3% and 14.25%, respectively, p < 0.001). Conclusion: Boosting PET/CT-positive areas in RT of GEJ tumors is feasible, but prospective trials are needed.
ER -
SLÁVIK, Marek, Petr BURKOŇ, Iveta SELINGEROVÁ, Pavel KRUPA, Tomáš KAZDA, Jaroslava STANKOVA, Tomas NIKL, Renata HEJNOVÁ, Zdeněk ŘEHÁK, Pavel OŠMERA, Tomáš PROCHÁZKA, Eva DVORAKOVA, Petr POSPÍŠIL, Peter GRELL, Pavel ŠLAMPA a Radka OBERMANNOVÁ. Preoperative Chemoradiotherapy for Gastroesophageal Junction Adenocarcinoma Modified by PET/CT: Results of Virtual Planning Study. \textit{Medicina-Lithuania}. Basel: MDPI, 2021, roč.~57, č.~12, s.~1-12. ISSN~1010-660X. Dostupné z: https://dx.doi.org/10.3390/medicina57121334.
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