Document Detail


Normal tissue complication probability analysis of acute gastrointestinal toxicity in cervical cancer patients undergoing intensity modulated radiation therapy and concurrent cisplatin.
MedLine Citation:
PMID:  22516388     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To test the hypothesis that increased bowel radiation dose is associated with acute gastrointestinal (GI) toxicity in cervical cancer patients undergoing concurrent chemotherapy and intensity-modulated radiation therapy (IMRT), using a previously derived normal tissue complication probability (NTCP) model.
METHODS: Fifty patients with Stage I-III cervical cancer undergoing IMRT and concurrent weekly cisplatin were analyzed. Acute GI toxicity was graded using the Radiation Therapy Oncology Group scale, excluding upper GI events. A logistic model was used to test correlations between acute GI toxicity and bowel dosimetric parameters. The primary objective was to test the association between Grade ≥2 GI toxicity and the volume of bowel receiving ≥45 Gy (V(45)) using the logistic model.
RESULTS: Twenty-three patients (46%) had Grade ≥2 GI toxicity. The mean (SD) V(45) was 143 mL (99). The mean V(45) values for patients with and without Grade ≥2 GI toxicity were 176 vs. 115 mL, respectively. Twenty patients (40%) had V(45) >150 mL. The proportion of patients with Grade ≥2 GI toxicity with and without V(45) >150 mL was 65% vs. 33% (p = 0.03). Logistic model parameter estimates V50 and γ were 161 mL (95% confidence interval [CI] 60-399) and 0.31 (95% CI 0.04-0.63), respectively. On multivariable logistic regression, increased V(45) was associated with an increased odds of Grade ≥2 GI toxicity (odds ratio 2.19 per 100 mL, 95% CI 1.04-4.63, p = 0.04).
CONCLUSIONS: Our results support the hypothesis that increasing bowel V(45) is correlated with increased GI toxicity in cervical cancer patients undergoing IMRT and concurrent cisplatin. Reducing bowel V(45) could reduce the risk of Grade ≥2 GI toxicity by approximately 50% per 100 mL of bowel spared.
Authors:
Daniel R Simpson; William Y Song; Vitali Moiseenko; Brent S Rose; Catheryn M Yashar; Arno J Mundt; Loren K Mell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  83     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-20     Completed Date:  2012-06-18     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e81-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents / adverse effects*,  therapeutic use
Chemoradiotherapy / adverse effects*
Cisplatin / adverse effects*,  therapeutic use
Female
Gastrointestinal Tract / pathology,  radiation effects*
Humans
Middle Aged
Organs at Risk / radiation effects
Radiation Injuries / pathology*
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted / methods
Radiotherapy, Intensity-Modulated / adverse effects*,  methods
Regression Analysis
Retrospective Studies
Uterine Cervical Neoplasms / pathology,  therapy*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; Q20Q21Q62J/Cisplatin

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