title: Predictive factors for pericardial effusion identified by heart dose-volume histogram analysis in oesophageal cancer patients treated with chemoradiotherapy.
abstract: OBJECTIVE
  To identify predictive factors for the development of pericardial effusion (PCE) in patients with oesophageal cancer treated with chemotherapy and radiotherapy (RT).
  
  
  METHODS
  From March 2006 to November 2012, patients with oesophageal cancer treated with chemoradiotherapy (CRT) using the following criteria were evaluated: radiation dose >50 Gy; heart included in the radiation field; dose-volume histogram (DVH) data available for analysis; no previous thoracic surgery; and no PCE before treatment. The diagnosis of PCE was independently determined by two radiologists. Clinical factors, the percentage of heart volume receiving >5-60 Gy in increments of 5 Gy (V5-60, respectively), maximum heart dose and mean heart dose were analysed.
  
  
  RESULTS
  A total of 143 patients with oesophageal cancer were reviewed retrospectively. The median follow-up by CT was 15 months (range, 2.1-72.6 months) after RT. PCE developed in 55 patients (38.5%) after RT, and the median time to develop PCE was 3.5 months (range, 0.2-9.9 months). On univariate analysis, DVH parameters except for V60 were significantly associated with the development of PCE (p < 0.001). No clinical factor was significantly related to the development of PCE. Recursive partitioning analysis including all DVH parameters as variables showed a V10 cut-off value of 72.8% to be the most influential factor.
  
  
  CONCLUSIONS
  The present results showed that DVH parameters are strong independent predictive factors for the development of PCE in patients with oesophageal cancer treated with CRT.
  
  
  CONCLUSIONS
  A heart dosage was associated with the development of PCE with radiation and without prophylactic nodal irradiation.
authors.affiliation: 1 Department of Radiology, Kansai Medical University, Hirakata, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: M
authors.initials: M
authors.lastname: Nomura
authors.forename: M
authors.initials: M
authors.lastname: Kamata
authors.forename: H
authors.initials: H
authors.lastname: Kojima
authors.forename: M
authors.initials: M
authors.lastname: Kohzai
authors.forename: K
authors.initials: K
authors.lastname: Sumita
authors.forename: N
authors.initials: N
authors.lastname: Tanigawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D049268:Positron-Emission Tomography / Q000379:methods*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents