Intensity-Modulated Radiation Therapy Significantly Improves Acute Gastrointestinal Toxicity in Pancreatic and Ampullary Cancers

Journal Article · Sat Jan 01 00:00:00 EST 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.10.043· OSTI ID:21491550

Yovino, Susannah ^[1]; Poppe, Matthew; Jabbour, Salma ^[2]; David, Vera; Garofalo, Michael ^[1]; Pandya, Naimesh ^[3]; Alexander, Richard; Hanna, Nader ^[4]

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1. Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States)
2. Department of Radiation Oncology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ (United States)
3. Department of Medical Oncology, University of Maryland School of Medicine, Baltimore, MD (United States)
4. Department of Surgical Oncology, University of Maryland School of Medicine, Baltimore, MD (United States)

Purpose: Among patients with upper abdominal malignancies, intensity-modulated radiation therapy (IMRT) can improve dose distributions to critical dose-limiting structures near the target. Whether these improved dose distributions are associated with decreased toxicity when compared with conventional three-dimensional treatment remains a subject of investigation. Methods and Materials: 46 patients with pancreatic/ampullary cancer were treated with concurrent chemoradiation (CRT) using inverse-planned IMRT. All patients received CRT based on 5-fluorouracil in a schema similar to Radiation Therapy Oncology Group (RTOG) 97-04. Rates of acute gastrointestinal (GI) toxicity for this series of IMRT-treated patients were compared with those from RTOG 97-04, where all patients were treated with three-dimensional conformal techniques. Chi-square analysis was used to determine if there was a statistically different incidence in acute GI toxicity between these two groups of patients. Results: The overall incidence of Grade 3-4 acute GI toxicity was low in patients receiving IMRT-based CRT. When compared with patients who had three-dimensional treatment planning (RTOG 97-04), IMRT significantly reduced the incidence of Grade 3-4 nausea and vomiting (0% vs. 11%, p = 0.024) and diarrhea (3% vs. 18%, p = 0.017). There was no significant difference in the incidence of Grade 3-4 weight loss between the two groups of patients. Conclusions: IMRT is associated with a statistically significant decrease in acute upper and lower GI toxicity among patients treated with CRT for pancreatic/ampullary cancers. Future clinical trials plan to incorporate the use of IMRT, given that it remains a subject of active investigation.

• OSTI ID: 21491550
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 79, Issue 1; Other Information: DOI: 10.1016/j.ijrobp.2009.10.043; PII: S0360-3016(09)03510-X; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
NEOPLASMS
PANCREAS
RADIATION DOSE DISTRIBUTIONS
RADIOTHERAPY
THREE-DIMENSIONAL CALCULATIONS
TOXICITY
URACILS
AZINES
BODY
DIGESTIVE SYSTEM
DISEASES
ENDOCRINE GLANDS
GLANDS
HETEROCYCLIC COMPOUNDS
HYDROXY COMPOUNDS
MEDICINE
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PYRIMIDINES
RADIOLOGY
THERAPY