title: Feasibility of tomotherapy to reduce normal lung and cardiac toxicity for distal esophageal cancer compared to three-dimensional radiotherapy.
abstract: OBJECTIVE
  To compare the effectiveness of tomotherapy and three-dimensional (3D) conformal radiotherapy to spare normal critical structures (spinal cord, lungs, and ventricles) from excessive radiation in patients with distal esophageal cancers.
  
  
  METHODS
  A retrospective dosimetric study of nine patients who had advanced gastro-esophageal (GE) junction cancer (7) or thoracic esophageal cancer (2) extending into the distal esophagus. Two plans were created for each of the patients. A three-dimensional plan was constructed with either three (anteroposterior, right posterior oblique, and left posterior oblique) or four (right anterior oblique, left anterior oblique, right posterior oblique, and left posterior oblique) fields. The second plan was for tomotherapy. Doses were 45 Gy to the PTV with an integrated boost of 5 Gy for tomotherapy.
  
  
  RESULTS
  Mean lung dose was respectively 7.4 and 11.8 Gy (p=0.004) for tomotherapy and 3D plans. Corresponding values were 12.4 and 18.3 Gy (p=0.006) for cardiac ventricles. Maximum spinal cord dose was respectively 31.3 and 37.4 Gy (p < 0.007) for tomotherapy and 3D plans. Homogeneity index was two for both groups.
  
  
  CONCLUSIONS
  Compared to 3D conformal radiotherapy, tomotherapy decreased significantly the amount of normal tissue irradiated and may reduce treatment toxicity for possible dose escalation in future prospective studies.
authors: Department of Radiation Oncology, University of Arizona, Tucson, AZ 85724-5081, USA. NamPhong.Nguyen@yahoo.com
authors: Nam P
authors: NP
authors: Nguyen
authors: Shane P
authors: SP
authors: Krafft
authors: Vincent
authors: V
authors: Vinh-Hung
authors: Paul
authors: P
authors: Vos
authors: Fabio
authors: F
authors: Almeida
authors: Siyoung
authors: S
authors: Jang
authors: Misty
authors: M
authors: Ceizyk
authors: Anand
authors: A
authors: Desai
authors: Rick
authors: R
authors: Davis
authors: Russ
authors: R
authors: Hamilton
authors: Homayoun
authors: H
authors: Modarresifar
authors: Dave
authors: D
authors: Abraham
authors: Lexie
authors: L
authors: Smith-Raymond
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000532:radiotherapy*; D005240:Feasibility Studies; D005260:Female; D006321:Heart / Q000528:radiation effects*; D006801:Humans; D008168:Lung / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000379:methods*; D012189:Retrospective Studies; D013116:Spinal Cord / Q000528:radiation effects