Severe intestinal toxicity after stereotactic ablative radiotherapy for abdominopelvic malignancies

Purpose The purpose of this study is to identify the predictors for severe intestinal toxicity (IT) in patients with abdominopelvic malignancies treated with three fractions of stereotactic ablative radiotherapy (SABR). Methods From 2001 to 2011, 202 patients with abdominopelvic malignancies were tr...

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Bibliographic Details
Published in:International journal of colorectal disease 2013-12, Vol.28 (12), p.1707-1713
Main Authors: Bae, Sun Hyun, Kim, Mi-Sook, Kim, So Young, Jang, Won Il, Cho, Chul Koo, Yoo, Hyung Jun, Kim, Kum Bae, Lee, Dong Han, Han, Chul Ju, Yang, Ki Young, Kim, Sang Bum
Format: Article
Language:English
Subjects:
Abdominal Neoplasms - pathology
Abdominal Neoplasms - surgery
Adult
Aged
Analysis
Cancer
Care and treatment
Female
Gastroenterology
Hepatology
Humans
Internal Medicine
Intestines - pathology
Kaplan-Meier Estimate
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Pelvic Neoplasms - pathology
Pelvic Neoplasms - surgery
Proctology
Prognosis
Radiosurgery - adverse effects
Radiotherapy
Radiotherapy Dosage
Republic of Korea
Surgery
Treatment Outcome
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Summary:Purpose The purpose of this study is to identify the predictors for severe intestinal toxicity (IT) in patients with abdominopelvic malignancies treated with three fractions of stereotactic ablative radiotherapy (SABR). Methods From 2001 to 2011, 202 patients with abdominopelvic malignancies were treated with curative-intent SABR. Among these, we retrospectively reviewed the clinical records of 55 patients with the presence of the intestine that received a dose ≥20 % of the prescribed dose. The total dose ranged from 33 to 60 Gy in three fractionations (median dose, 45 Gy). We analyzed the clinical and dosimetric parameters for severe IT ≥ grade 3 according to the National Cancer Institute Common Toxicity Criteria v4.0: V 20–35 (volume of the intestine that received x Gy) and D max (maximum point dose). Results Severe IT was found in six patients (the median time, 3 months). V 25 was the best dosimetric predictor for severe IT ( P  = 0.004). With V 25  ≤ 20 ml, severe IT decreased from 50 to 4 %. SABR duration was the best clinical predictor. Severe IT decreased in patients who received SABR at 4–8 days than on three consecutive days (0 vs. 18 %, P  = 0.037). Conclusions Following three fractions of SABR, V 25 is a valuable predictor of severe IT. And SABR would be conducted with a treatment interval of at least 48 h if possible.
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-013-1717-6