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This study sought to establish whether the spleen receives a significant incidental radiation dose when treating distal oesophageal carcinoma with the standardised dCRT or radical radiotherapy doses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this single\u2010centre retrospective study, all patients (<jats:italic>n<\/jats:italic>\u2009=\u200934) with distal oesophageal cancer, treated with either dCRT or radical radiotherapy over an 18\u2010month period using a volumetric modulated arc therapy (VMAT) planning technique, were included. The median age was 74\u2009years old: 56% were male; 50% (<jats:italic>n<\/jats:italic>\u2009=\u200917) had adenocarcinoma and 41% (<jats:italic>n<\/jats:italic>\u2009=\u200914) had squamous carcinoma. The majority (79%) received dCRT with a prescribed dose of 50\u2009Gy in 25 fractions while the other 21% of patients were treated with radical radiotherapy alone (55\u2009Gy in 20 fractions). The spleen was retrospectively contoured by one physician, and the V<jats:sub>10 Gy<\/jats:sub> and mean splenic dose (MSD) were calculated using Eclipse planning software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median MSD was 14.4\u2009Gy with a range of 0.75\u201328.3\u2009Gy. The median V<jats:sub>10 Gy<\/jats:sub> was 62.7%. Of the cohort, 67.6% received an MSD of more than 10\u2009Gy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Two\u2010thirds of the patients received a dose of more than the 10\u2009Gy. A review of the literature suggests that higher splenic radiation doses may increase the long\u2010term risk of infection and impact on other outcomes. This study provides important evidence that the spleen receives a significant dose of radiation when treating distal oesophageal cancer and should be considered as an organ at risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1754-9485.13310","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T08:53:57Z","timestamp":1629276837000},"page":"925-930","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Coincidental splenic irradiation and risk of functional hyposplenism in oesophageal cancer treatment"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5475-8912","authenticated-orcid":false,"given":"Rachel","family":"Ellis","sequence":"first","affiliation":[{"name":"Northern Ireland Cancer Centre Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aidan J","family":"Cole","sequence":"additional","affiliation":[{"name":"Northern Ireland Cancer Centre Belfast UK"},{"name":"Centre for Medical Education Queen\u2019s University Belfast Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolyne","family":"O\u2019Hare","sequence":"additional","affiliation":[{"name":"Northern Ireland Cancer Centre Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn","family":"Whitten","sequence":"additional","affiliation":[{"name":"Northern Ireland Cancer Centre Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Crowther","sequence":"additional","affiliation":[{"name":"Northern Ireland Cancer Centre Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Harrison","sequence":"additional","affiliation":[{"name":"Northern Ireland Cancer Centre Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,18]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Cancer Research UK [Internet].London:CRUK; cited March 2020. 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