Comparison of Acute Gastrointestinal Toxicity of Intensity-Modulated Radiotherapy Versus Three-Dimensional Conformal Radiotherapy in Patients of Carcinoma Cervix.

Autor:	Padhi S; Radiation Oncology, Acharya Harihar Post Graduate Institute of Cancer, Cuttack, IND., Mahapatra BR; Radiation Oncology, Utkal Hospital, Bhubaneswar, IND., Pati KC; Community Medicine, Fakir Mohan Medical College and Hospital, Balasore, IND., Sahoo B; Radiation Oncology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND., Kanungo S; Radiation Oncology, Postgraduate Institute of Medical Education & Research (PGIMER) and Capital Hospital, Bhubaneswar, IND., Mishra T; Radiation Oncology, ESI Hospital, Bhubaneswar, IND., Muraleedharan A; Radiation Oncology, All India Institute of Medical Sciences, Bhubaneswar, IND.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Nov 16; Vol. 15 (11), pp. e48876. Date of Electronic Publication: 2023 Nov 16 (Print Publication: 2023).
DOI:	10.7759/cureus.48876
Abstrakt:	Introduction Cervical cancer is the most common gynaecological malignancy worldwide, with a higher prevalence in middle- and low-income countries. Chemoradiotherapy, followed by intracavitary brachytherapy, is the treatment of choice in locally advanced cervical cancer. The most common acute side effect of external beam radiotherapy (EBRT) is bowel toxicity in the form of diarrhoea and abdominal cramps. The treatment techniques of EBRT were revolutionised with the advent of intensity modulation. This study aims to prospectively analyse whether the dosimetric advantage of intensity-modulated radiotherapy (IMRT) over three-dimensional conformal radiotherapy (3DCRT) is translated clinically into a decrease in acute toxicity. Method Twenty-four patients were randomised into two groups: the 3DCRT and the IMRT. Acute gastrointestinal (GI) toxicity was assessed during treatment using radiation therapy oncology group grading. The factors under consideration were age, stage of the disease, treatment technique, chemotherapy, and the intention of therapy (radical or adjuvant). The mean bowel bag dose of the two techniques was analysed. Result Among the factors under consideration, it was found that the treatment technique was the only factor that had a significant association with acute bowel toxicity in both univariate (p = 0.036) and multivariate analyses (p = 0.028). The mean V25 (the volume receiving 25 Gy), V45, and V50 of the bowel bag in the IMRT arm were significantly less than the 3DCRT arm. Grades 2 and 3 acute bowel toxicities were also higher in the 3DCRT arm. Conclusion The treatment technique is essential to determining acute GI toxicity during pelvic radiotherapy. With IMRT, the dose to the bowel bag and, in turn, the acute bowel toxicity can be reduced. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Padhi et al.)
Databáze:	MEDLINE
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