Avoidance of small intestine injury in gynecologic cancer
The evolution of systematized operative staging and radical surgical procedures in the management of gynecologic cancer has increased the complexities of integrating radiation therapy. High dose irradiation to large treatment volumes has been associated with an increased incidence of small intestine injury. This complication is morbid and often fatal. Although predisposing factors have been extensively studied, there has been a paucity of reports evaluating preventative measures. Between 1975 and 1980, 140 patients with gynecologic cancer were treated at the Valley Presbyterian Hospital in the Division of Radiation Therapy. Twenty-six patients with cervix cancer received definitive irradiation and seven received adjunct irradiation. Seventy-two with corpus cancer received adjunct irradiation, seven received definitive irradiation and three palliative irradiation. Eleven patients with ovarian cancer received adjunct irradiation and 15 palliative irradiation. Eight-five patients were at potential risk for small intestine injury and had treatment planning small intestine x rays. Fixation was observed in 7/39 (18%) without prior pelvic surgery and 30/46 (65%) with prior pelvic surgery. Information from the small intestine x rays were used in 41 patients to make 60 treatment modifications. Twenty-five of 140 (17%) had a reduction of total dose, 26/140 (18%) had exclusion of the small intestine by shrinking fields, or patient positioning and 13/140 (9%) had displacement of the small intestine by distension of the bladder. No patient developed small intestine injury. The disease free survival for cervix cancer 27/33 (82%), corpus cancer 68/79 (86%) and ovarian cancer 5/11 (45%).
- Research Organization:
- Univ. of Southern California, Los Angeles
- OSTI ID:
- 5378363
- Journal Information:
- Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 9:9; ISSN IOBPD
- Country of Publication:
- United States
- Language:
- English
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560151* -- Radiation Effects on Animals-- Man
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANIMALS
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
CARCINOMAS
DELAYED RADIATION EFFECTS
DIGESTIVE SYSTEM
DIGESTIVE SYSTEM DISEASES
DISEASES
ELECTROMAGNETIC RADIATION
ENERGY RANGE
ENTERITIS
FEMALE GENITALS
FEMALES
GASTROINTESTINAL TRACT
HARD X RADIATION
INTESTINES
IONIZING RADIATIONS
MAMMALS
MAN
MEDICINE
MEV RANGE
MEV RANGE 01-10
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
PRIMATES
RADIATION EFFECTS
RADIATIONS
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SMALL INTESTINE
THERAPY
UTERUS
VERTEBRATES
WOMEN
X RADIATION