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Title: Predictor of Severe Gastroduodenal Toxicity After Stereotactic Body Radiotherapy for Abdominopelvic Malignancies

Abstract

Purpose: To identify the predictors for the development of severe gastroduodenal toxicity (GDT) in patients treated with stereotactic body radiotherapy (SBRT) using 3 fractionations for abdominopelvic malignancies. Methods and Materials: From 2001 to 2011, 202 patients with abdominopelvic malignancies were treated with curative-intent SBRT. Among these patients, we retrospectively reviewed the clinical records of 40 patients with the eligibility criteria as follows: 3 fractionations, follow-up period {>=}1 year, absence of previous radiation therapy (RT) history or combination of external-beam RT and the presence of gastroduodenum (GD) that received a dose higher than 20% of prescribed dose. The median SBRT dose was 45 Gy (range, 33-60 Gy) with 3 fractions. We analyzed the clinical and dosimetric parameters, including multiple dose-volume histogram endpoints: V{sub 20} (volume of GD that received 20 Gy), V{sub 25}, V{sub 30}, V{sub 35}, and D{sub max} (the maximum point dose). The grade of GDT was defined by the National Cancer Institute Common Toxicity Criteria version 4.0, and GDT {>=}grade 3 was defined as severe GDT. Results: The median time to the development of severe GDT was 6 months (range, 3-12 months). Severe GDT was found in 6 patients (15%). D{sub max} was the best dosimetric predictor formore » severe GDT. D{sub max} of 35 Gy and 38 Gy were respectively associated with a 5% and 10% probability of the development of severe GDT. A history of ulcer before SBRT was the best clinical predictor on univariate analysis (P=.0001). Conclusions: We suggest that D{sub max} is a valuable predictor of severe GDT after SBRT using 3 fractionations for abdominopelvic malignancies. A history of ulcer before SBRT should be carefully considered as a clinical predictor, especially in patients who receive a high dose to GD.« less

Authors:
 [1];  [1]; ; ; ;  [1];  [2]; ;  [3];  [4]
  1. Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)
  2. CyberKnife Center, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)
  3. Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)
  4. Department of General Surgery, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)
Publication Date:
OSTI Identifier:
22149633
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 4; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; GY RANGE 10-100; NEOPLASMS; PATIENTS; PROBABILITY; RADIATION DOSES; RADIOTHERAPY; TOXICITY; ULCERS

Citation Formats

Bae, Sun Hyun, Kim, Mi-Sook, E-mail: mskim@kcch.re.kr, Cho, Chul Koo, Kang, Jin-Kyu, Lee, Sang Yeob, Lee, Kyung-Nam, Lee, Dong Han, Han, Chul Ju, Yang, Ki Young, and Kim, Sang Bum. Predictor of Severe Gastroduodenal Toxicity After Stereotactic Body Radiotherapy for Abdominopelvic Malignancies. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2012.06.005.
Bae, Sun Hyun, Kim, Mi-Sook, E-mail: mskim@kcch.re.kr, Cho, Chul Koo, Kang, Jin-Kyu, Lee, Sang Yeob, Lee, Kyung-Nam, Lee, Dong Han, Han, Chul Ju, Yang, Ki Young, & Kim, Sang Bum. Predictor of Severe Gastroduodenal Toxicity After Stereotactic Body Radiotherapy for Abdominopelvic Malignancies. United States. doi:10.1016/J.IJROBP.2012.06.005.
Bae, Sun Hyun, Kim, Mi-Sook, E-mail: mskim@kcch.re.kr, Cho, Chul Koo, Kang, Jin-Kyu, Lee, Sang Yeob, Lee, Kyung-Nam, Lee, Dong Han, Han, Chul Ju, Yang, Ki Young, and Kim, Sang Bum. Thu . "Predictor of Severe Gastroduodenal Toxicity After Stereotactic Body Radiotherapy for Abdominopelvic Malignancies". United States. doi:10.1016/J.IJROBP.2012.06.005.
@article{osti_22149633,
title = {Predictor of Severe Gastroduodenal Toxicity After Stereotactic Body Radiotherapy for Abdominopelvic Malignancies},
author = {Bae, Sun Hyun and Kim, Mi-Sook, E-mail: mskim@kcch.re.kr and Cho, Chul Koo and Kang, Jin-Kyu and Lee, Sang Yeob and Lee, Kyung-Nam and Lee, Dong Han and Han, Chul Ju and Yang, Ki Young and Kim, Sang Bum},
abstractNote = {Purpose: To identify the predictors for the development of severe gastroduodenal toxicity (GDT) in patients treated with stereotactic body radiotherapy (SBRT) using 3 fractionations for abdominopelvic malignancies. Methods and Materials: From 2001 to 2011, 202 patients with abdominopelvic malignancies were treated with curative-intent SBRT. Among these patients, we retrospectively reviewed the clinical records of 40 patients with the eligibility criteria as follows: 3 fractionations, follow-up period {>=}1 year, absence of previous radiation therapy (RT) history or combination of external-beam RT and the presence of gastroduodenum (GD) that received a dose higher than 20% of prescribed dose. The median SBRT dose was 45 Gy (range, 33-60 Gy) with 3 fractions. We analyzed the clinical and dosimetric parameters, including multiple dose-volume histogram endpoints: V{sub 20} (volume of GD that received 20 Gy), V{sub 25}, V{sub 30}, V{sub 35}, and D{sub max} (the maximum point dose). The grade of GDT was defined by the National Cancer Institute Common Toxicity Criteria version 4.0, and GDT {>=}grade 3 was defined as severe GDT. Results: The median time to the development of severe GDT was 6 months (range, 3-12 months). Severe GDT was found in 6 patients (15%). D{sub max} was the best dosimetric predictor for severe GDT. D{sub max} of 35 Gy and 38 Gy were respectively associated with a 5% and 10% probability of the development of severe GDT. A history of ulcer before SBRT was the best clinical predictor on univariate analysis (P=.0001). Conclusions: We suggest that D{sub max} is a valuable predictor of severe GDT after SBRT using 3 fractionations for abdominopelvic malignancies. A history of ulcer before SBRT should be carefully considered as a clinical predictor, especially in patients who receive a high dose to GD.},
doi = {10.1016/J.IJROBP.2012.06.005},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}