Esophageal Cancer Clinical Trial
Official title:
Organ Motion and Early Tumor Response Measurement During Chemotherapy for Esophageal Cancer
To quantify motion based variation of the target volume of the primary tumor over the course of chemoradiotherapy in esophageal cancer patients, and to use this information to calculate appropriate PTV (planning target volume) margins according to the margins recipe for patients receiving trimodality (neoadjuvant chemoradiation and surgery) or definitive chemoradiation in order to personalize radiation treatment, resulting in either better target coverage or a reduction in normal tissue radiation exposure.
A single center prospective observational study will be performed in esophageal cancer
patients. This study registers motion of the esophageal tumor, using 4D planning CT scans and
repeated 4D CBCT scanning. Motion of fiducial markers inserted into the esophageal wall, will
be used as a surrogate for tumor motion in the limited image quality of CBCT scans.
Patients planned for trimodality treatment will additionally be imaged by serial 4D Pet CT
and MRI in week 0 (before start chemoradiotherapy), week 3 (during chemoradiotherapy) and
week 10 (just prior to surgery) to observe (early) signs of tumor response.
Patients planned for definitive chemoradiation will not receive extra MRI imaging during
treatment because of the inability to correlate this imaging with pathological response.
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