Department of Radiology, Keio University, School of Medicine, Tokyo, Japan.
J Radiat Res. 2012;53(3):447-53. doi: 10.1269/jrr.11194.
We investigated the incidences of pericardial and pleural effusions after definitive radiotherapy with or without concurrent chemotherapy were analyzed retrospectively.
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.
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.
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.
我们回顾性分析了接受根治性放疗或放化疗（CCR）后并发心包和胸腔积液的发生率。
147 例食管癌患者接受根治性放疗或同步放化疗。通过随访胸部 CT 扫描来检测心包和胸腔积液。不良反应根据放射治疗肿瘤协作组的常见毒性标准进行分级。
中位随访时间为 34 个月（范围 6 至 84 个月）。分别有 107 例和 101 例患者可评估心包和胸腔积液。心包积液≥1 级和≥2 级毒性的患者分别为 46 例（43%）和 15 例（14%）。胸腔积液≥1 级和≥2 级毒性的患者分别为 44 例（44%）和 18 例（18%）。积液发生时间为治疗后 1 至 65 个月。多变量分析显示纵隔照射野宽度超过 8cm 是心包和胸腔积液的显著危险因素。年龄和照射野长度超过 20cm 是胸腔积液的独立危险因素。
放疗或 CCR 后心包和胸腔积液偶尔被认为是食管癌患者的不良反应。纵隔放射野宽度可以作为预测这些不良反应的一个简单指标。
