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Volumetric modulated arc therapy (VMAT) in the treatment of esophageal cancer patients

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Abstract

The aim of the study is to evaluate feasibility, safety, toxicity profile, and dosimetric results of volumetric modulated arc therapy (VMAT) to deliver definitive or pre-operative radiation in locally advanced esophageal cancer patients. A total of 68 patients were treated with VMAT between March 2014 and March 2018 (44% vs 56% for definitive and neoadjuvant settings, respectively). Dose prescription differed depending on the clinical scenario (54–60 Gy in 30 fractions for definitive treatments; 41.4/45 Gy in 23–25 fractions in the pre-operative setting). Most of the patients were given concurrent chemotherapy. Two coplanar and one non-coplanar arcs were employed for VMAT delivery. Treatment was generally well tolerated. Acute toxicity was generally mild. In patients treated with definitive intent, ≥ G3 toxicities were observed for esophagitis (30%), anorexia (26.7%), fatigue (26.7%), nausea (6.7%), and vomiting (3.3%). In patients treated within a neoadjuvant approach, ≥ G3 anorexia (21%), esophagitis (15.8%), fatigue (13.3%), nausea (5.3%), and vomiting (2.6%) were observed. Dosimetric results were consistent in term of both target coverage and normal tissue sparing. In conclusion, VMAT proved to be a feasible, safe, and effective strategy to deliver definitive or pre-operative radiation in locally advanced esophageal cancer patients.

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Authors and Affiliations

  1. Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy

    Stefania Martini, Francesca Arcadipane, Christian Fiandra, Riccardo Ragona, Umberto Ricardi & Pierfrancesco Franco

  2. Department of Surgery, General Surgery 2U and Liver Transplantation Center, University of Turin, AOU Citta’ della Salute e della Scienza, Turin, Italy

    Paolo Strignano, Giorgia Catalano & Renato Romagnoli

  3. Department of Oncology, Medical Oncology 1, AOU Citta’ della Salute e della Scienza, Turin, Italy

    Rosella Spadi

  4. Department of Oncology, Medical Oncology 2, AOU Citta’ della Salute e della Scienza, Turin, Italy

    Viviana Contu

  5. Department of Oncology, Medical Oncology 1, University of Torino, Turin, Italy

    Maria Antonietta Satolli

  6. Department of Surgical Sciences, University of Turin, Turin, Italy

    Michele Camandona

  7. Department of Oncology – Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy

    Pierfrancesco Franco

Authors
  1. Stefania Martini
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  2. Francesca Arcadipane
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  3. Paolo Strignano
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  4. Rosella Spadi
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  5. Viviana Contu
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  6. Christian Fiandra
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  7. Riccardo Ragona
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  8. Giorgia Catalano
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  9. Maria Antonietta Satolli
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  11. Renato Romagnoli
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  12. Umberto Ricardi
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  13. Pierfrancesco Franco
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Corresponding author

Correspondence to Pierfrancesco Franco.

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We declare that we do not have any conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The present study has been reviewed and approved by the Internal Review Board of the Department of Oncology of the University of Turin at AOU Citta’ della Salute e della Scienza, Turin, Italy.

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Martini, S., Arcadipane, F., Strignano, P. et al. Volumetric modulated arc therapy (VMAT) in the treatment of esophageal cancer patients. Med Oncol 35, 150 (2018). https://doi.org/10.1007/s12032-018-1211-7

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