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Abstract：
BACKGROUND: Radiation therapy plays a pivotal role as the primary adjuvant treatment for esophageal cancer (EPC), emphasizing the critical importance of carefully balancing radiation doses to the target area and organs at risk in the radiotherapeutic management of esophageal cancer.
OBJECTIVE: This study aimed to explore the correlation between morphological parameters and dosimetric parameters of the heart and spinal cord in intermediate- and advanced-stage esophagus cancer to provide a reference for clinical treatment.
RESULTS: A total of 105 patients with intermediate- and advanced-stage EPC, who received treatment in our hospital from 2019 to 2021, were included. The morphological parameters were calculated by imaging. Intensity-modulated radiation therapy plan was executed at Raystation4.7. The PTV-G stood for the externally expanded planning target volume (PTV) of the gross tumor volume (GTV) and PTV-C for the externally expanded volume of the clinical target volume (CTV). The prescription dose of PTV-G and PTV-C was set as 60Gy/30F and 54Gy/30F, respectively. The linear regression model was used to analyze the correlation between morphologic parameters of EPC and dosimetric parameters of the heart and spinal cord. In 105 cases, the total lung length was correlated with the spinal cord maximum dose (D2 ). The heart mean doses (Dmean ) and heart V40 (the relative volume that receives 40 Gy or more) was correlated with PTV-G volume, PTV-G length; In middle- and upper-segment EPC cases, only the total lung volume was correlated with the spinal cord Dmean , spinal cord D2 , heart Dmean , and heart V40 ; In middle-stage EPC cases, the heart Dmean was correlated with the PTV-G volume, PTV-G length. The total lung length was correlated with the spinal cord D2 ; In middle- and lower-segment EPC, only the PTV-G volume and PTV-G length were correlated with the heart Dmean . All the aforementioned values were statistically significant.
CONCLUSIONS: Combined with the unsegmented tumor and different locations, the organ at risk dose was comprehensively considered.
OBJECTIVE: This study aimed to explore the correlation between morphological parameters and dosimetric parameters of the heart and spinal cord in intermediate- and advanced-stage esophagus cancer to provide a reference for clinical treatment.
RESULTS: A total of 105 patients with intermediate- and advanced-stage EPC, who received treatment in our hospital from 2019 to 2021, were included. The morphological parameters were calculated by imaging. Intensity-modulated radiation therapy plan was executed at Raystation4.7. The PTV-G stood for the externally expanded planning target volume (PTV) of the gross tumor volume (GTV) and PTV-C for the externally expanded volume of the clinical target volume (CTV). The prescription dose of PTV-G and PTV-C was set as 60Gy/30F and 54Gy/30F, respectively. The linear regression model was used to analyze the correlation between morphologic parameters of EPC and dosimetric parameters of the heart and spinal cord. In 105 cases, the total lung length was correlated with the spinal cord maximum dose (D2 ). The heart mean doses (Dmean ) and heart V40 (the relative volume that receives 40 Gy or more) was correlated with PTV-G volume, PTV-G length; In middle- and upper-segment EPC cases, only the total lung volume was correlated with the spinal cord Dmean , spinal cord D2 , heart Dmean , and heart V40 ; In middle-stage EPC cases, the heart Dmean was correlated with the PTV-G volume, PTV-G length. The total lung length was correlated with the spinal cord D2 ; In middle- and lower-segment EPC, only the PTV-G volume and PTV-G length were correlated with the heart Dmean . All the aforementioned values were statistically significant.
CONCLUSIONS: Combined with the unsegmented tumor and different locations, the organ at risk dose was comprehensively considered.
摘要：
背景：放射治疗作为食管癌（EPC）的主要辅助治疗起着关键作用，强调在食管癌的放射治疗管理中，仔细平衡靶区和危险器官的放射剂量至关重要。
目的：本研究旨在探讨中、晚期食管癌心、脊髓形态学参数与剂量学参数的相关性，为临床治疗提供参考。
结果：共有105例中晚期EPC患者，包括2019年至2021年在我们医院接受治疗的患者。通过成像计算形态学参数。调强放射治疗计划在Raystation4.7执行。PTV-G代表总肿瘤体积(GTV)的外部扩展计划靶体积(PTV),PTV-C代表临床靶体积(CTV)的外部扩展体积。PTV-G和PTV-C的处方剂量设定为60Gy/30F和54Gy/30F,分别。采用线性回归模型分析EPC形态学参数与心脏和脊髓剂量学参数的相关性。在105个案例中，肺总长度与脊髓最大剂量（D2）相关。心脏平均剂量（Dmean）和心脏V40（接受40Gy或更多的相对体积）与PTV-G体积相关，PTV-G长度；在中段和上段EPC病例中，只有总肺容积与脊髓Dmean相关，脊髓D2,心脏Dmean,和心脏V40；在中期EPC病例中，心脏Dmean与PTV-G体积相关，PTV-G长度。总肺长度与脊髓D2相关；在中段和下段EPC中，只有PTV-G体积和PTV-G长度与心脏Dmean相关。所有上述值均具有统计学意义。
结论：结合未分割的肿瘤和不同的位置，综合考虑了危险器官的剂量。
目的：本研究旨在探讨中、晚期食管癌心、脊髓形态学参数与剂量学参数的相关性，为临床治疗提供参考。
结果：共有105例中晚期EPC患者，包括2019年至2021年在我们医院接受治疗的患者。通过成像计算形态学参数。调强放射治疗计划在Raystation4.7执行。PTV-G代表总肿瘤体积(GTV)的外部扩展计划靶体积(PTV),PTV-C代表临床靶体积(CTV)的外部扩展体积。PTV-G和PTV-C的处方剂量设定为60Gy/30F和54Gy/30F,分别。采用线性回归模型分析EPC形态学参数与心脏和脊髓剂量学参数的相关性。在105个案例中，肺总长度与脊髓最大剂量（D2）相关。心脏平均剂量（Dmean）和心脏V40（接受40Gy或更多的相对体积）与PTV-G体积相关，PTV-G长度；在中段和上段EPC病例中，只有总肺容积与脊髓Dmean相关，脊髓D2,心脏Dmean,和心脏V40；在中期EPC病例中，心脏Dmean与PTV-G体积相关，PTV-G长度。总肺长度与脊髓D2相关；在中段和下段EPC中，只有PTV-G体积和PTV-G长度与心脏Dmean相关。所有上述值均具有统计学意义。
结论：结合未分割的肿瘤和不同的位置，综合考虑了危险器官的剂量。
