Change in Creatinine Clearance Over Time Following Upper Abdominal Irradiation
| Autor: | Mary F. Mulcahy, Alfred Rademaker, William Small, John M Boyle, Z. Kang, Krystyna Kiel, Virginia M. Diavolitsis |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Dose-volume histogram Multivariate analysis Adolescent medicine.medical_treatment Urology Renal function Kidney Volume Kidney Kidney Function Tests Young Adult chemistry.chemical_compound medicine Humans Radiation Injuries Aged Gastrointestinal Neoplasms Neoplasm Staging Aged 80 and over Creatinine business.industry Radiotherapy Dosage Middle Aged Surgery Survival Rate Radiation therapy Treatment Outcome medicine.anatomical_structure Oncology chemistry Population study Female business Follow-Up Studies |
| Zdroj: | American Journal of Clinical Oncology. 34:53-57 |
| ISSN: | 0277-3732 |
| Popis: | OBJECTIVES To investigate the change in creatinine clearance (CrCl) over time following upper abdominal radiation utilizing a dose-volume histogram (DVH) multivariate analysis. METHODS The study population included 125 patients with gastrointestinal malignancy treated with abdominal radiation therapy at our institution between 1994 and 2006, with available creatinine and DVH information. Kidney dose-volume data collected included mean kidney dose, volume of kidney irradiated, V5, V10, and V20 of total kidney volume, and number of mL of kidney greater than and less than 20 Gy. RESULTS With a median follow-up of 2.4 years, and a mean kidney dose of 16.2 Gy, a significant correlation between decrease in CrCl and irradiated kidney volume observed was noted for all DVH parameters. The strongest correlations were found when using V5, V10, and number of mL of kidney treated to greater than 20 Gy. There was no significant change in number of antihypertensive medications taken by patients over time, and no relationship between outcome variables and pre-existing comorbidities. CONCLUSIONS This is the first study that we are aware of comparing DVH data with measurement of renal toxicity. We show significant correlations between dose and volume irradiated and decline in renal function. This will be clinically useful when determining a treatment plan for patients with borderline preradiation CrCl and provides evidence that minimizing radiation to the kidney could have important clinical ramifications. |
| Databáze: | OpenAIRE |
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