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The effect of dose escalation on gastric toxicity when treating lower oesophageal tumours: a radiobiological investigation

Carrington, Rhys, Staffurth, John Nicholas ORCID:, Warren, Samantha, Partridge, Mike, Hurt, Chris Nicholas ORCID:, Spezi, Emiliano ORCID:, Gwynne, Sarah, Hawkins, Maria A. and Crosby, Thomas 2015. The effect of dose escalation on gastric toxicity when treating lower oesophageal tumours: a radiobiological investigation. Radiation Oncology 10 , 236. 10.1186/s13014-015-0537-y

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Purpose Using radiobiological modelling to estimate normal tissue toxicity, this study investigates the effects of dose escalation for concurrent chemoradiation therapy (CRT) in lower third oesophageal tumours on the stomach. Methods and materials 10 patients with lower third oesophageal cancer were selected from the SCOPE 1 database (ISCRT47718479) with a mean planning target volume (PTV) of 348 cm3. The original 3D conformal plans (50Gy3D) were compared to newly created RapidArc plans of 50GyRA and 60GyRA, the latter using a simultaneous integrated boost (SIB) technique using a boost volume, PTV2. Dose-volume metrics and estimates of normal tissue complication probability (NTCP) were compared. Results There was a significant increase in NTCP of the stomach wall when moving from the 50GyRA to the 60GyRA plans (11–17 %, Wilcoxon signed rank test, p = 0.01). There was a strong correlation between the NTCP values of the stomach wall and the volume of the stomach wall/PTV 1 and stomach wall/PTV2 overlap structures (R = 0.80 and R = 0.82 respectively) for the 60GyRA plans. Conclusion Radiobiological modelling suggests that increasing the prescribed dose to 60Gy may be associated with a significantly increased risk of toxicity to the stomach. It is recommended that stomach toxicity be closely monitored when treating patients with lower third oesophageal tumours with 60Gy.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Engineering
Subjects: T Technology > TA Engineering (General). Civil engineering (General)
Additional Information: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Publisher: BioMed Central
ISSN: 1748-717X
Date of First Compliant Deposit: 30 March 2016
Date of Acceptance: 4 November 2015
Last Modified: 21 Oct 2023 01:08

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