title: Cardiac function after chemoradiation for esophageal cancer: comparison of heart dose-volume histogram parameters to multiple gated acquisition scan changes.
abstract: In this paper we determine if preoperative chemoradiation for locally advanced esophageal cancer leads to changes in cardiac ejection fraction. This is a retrospective review of 20 patients treated at our institution for esophageal cancer between 2000 and 2002. Multiple gated acquisition cardiac scans were obtained before and after platinum-based chemoradiation (50.4 Gy). Dose-volume histograms for heart, left ventricle and left anterior descending artery were analyzed. Outcomes assessed included pre- and postchemoradiation ejection fraction ratio and percentage change in ejection fraction postchemoradiation. A statistically significant difference was found between median prechemoradiation ejection fraction (59%) and postchemoradiation ejection fraction (54%) (P = 0.01), but the magnitude of the difference was not clinically significant. Median percentage volume of heart receiving more than 20, 30 and 40 Gy were 61.5%, 58.5% and 53.5%, respectively. Our data showed a clinically insignificant decline in ejection fraction following chemoradiation for esophageal cancer. We did not observe statistically or clinically significant associations between radiation dose to heart, left ventricle or left anterior descending artery and postchemoradiation ejection fraction.
authors.affiliation: Department of Radiation Oncology, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
authors.forename: P
authors.initials: P
authors.lastname: Tripp
authors.forename: H K
authors.initials: HK
authors.lastname: Malhotra
authors.forename: M
authors.initials: M
authors.lastname: Javle
authors.forename: A
authors.initials: A
authors.lastname: Shaukat
authors.forename: R
authors.initials: R
authors.lastname: Russo
authors.forename: S
authors.initials: S
authors.lastname: De Boer
authors.forename: M
authors.initials: M
authors.lastname: Podgorsak
authors.forename: H
authors.initials: H
authors.lastname: Nava
authors.forename: G Y
authors.initials: GY
authors.lastname: Yang
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy*; D005069:Evaluation Studies as Topic; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D015637:Gated Blood-Pool Imaging; D006321:Heart / Q000000981:diagnostic imaging / Q000528:radiation effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013318:Stroke Volume / Q000528:radiation effects
chemical_list: D002945:Cisplatin; D005472:Fluorouracil