Pericardial and pleural effusions after definitive radiotherapy for esophageal cancer.
OBJECTIVE
We investigated the incidences of pericardial and pleural effusions after definitive radiotherapy with or without concurrent chemotherapy were analyzed retrospectively.


METHODS
One hundred and forty-seven patients with esophageal cancer received definitive radiotherapy or concurrent chemoradiotherapy (CCR). Follow-up chest Computed Tomography scans were reviewed to detect pericardial and pleural effusions. Adverse events were graded according to the Radiation Therapy Oncology Group Common Toxicity Criteria.


RESULTS
The median follow-up was 34 (range, 6 to 84) months. Numbers of eligible patients evaluated for pericardial and pleural effusions were 107 and 101, respectively. Pericardial effusions exceeding grade 1 and grade 2 toxicities were observed in 46 (43%) and 15 (14%) patients, respectively. The corresponding numbers for pleural effusions were 44 (44%) and 18 (18%). Onset of effusion ranged from 1 to 65 months after treatment. Multivariate analysis identified radiation field width of the mediastinum exceeding 8 cm as a significant risk factor for both pericardial and pleural effusions. Age and field length exceeding 20 cm were identified as independent risk factors for pleural effusion.


CONCLUSIONS
Pericardial and pleural effusions after radiotherapy or CCR are occasionally recognized as adverse events in patients with esophageal cancer. The mediastinal radiation field width can be a simple indicator for predicting those adverse events.
Department of Radiology, Keio University, School of Medicine, Tokyo, Japan. fukada@rad.med.keio.ac.jp
Junichi
J
Fukada
Naoyuki
N
Shigematsu
Toshio
T
Ohashi
Yutaka
Y
Shiraishi
Hiroya
H
Takeuchi
Osamu
O
Kawaguchi
Yuko
Y
Kitagawa
D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000532:radiotherapy* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000209:etiology*; D010996:Pleural Effusion / Q000209:etiology*; D011832:Radiation Injuries / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors