Digestive toxicities after palliative three-dimensional conformal radiation therapy (3D-CRT) for cervico-thoracic spinal metastases
| Autor: | T. Lizée, Yoann Pointreau, Gérard Ganem, Cedrik Lafond, Guillaume Peyraga, Yann Metayer, Fabrice Denis, Sophie Roche, Olivier Dupuis, Delphine Caron, Anne-Lise Septans |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Palliative care Nausea Gastrointestinal Diseases Vomiting medicine.medical_treatment Bone Neoplasms 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine Humans Esophagus Radiation Injuries Aged Retrospective Studies Aged 80 and over Spinal Neoplasms business.industry Palliative Care Radiotherapy Dosage Middle Aged Thoracic Neoplasms medicine.disease Radiation therapy medicine.anatomical_structure Oncology Head and Neck Neoplasms 030220 oncology & carcinogenesis Thoracic vertebrae Premedication Female Radiology Radiotherapy Intensity-Modulated medicine.symptom Radiotherapy Conformal business Esophagitis |
| Zdroj: | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 26(6) |
| ISSN: | 1433-7339 |
| Popis: | The palliative treatment for cervico-thoracic spinal metastases is based on a three-dimensional conformal radiation therapy (3D-CRT). Digestive toxicities are common and cause a clinical impact frequently underestimated in patients. We performed a retrospective study of digestive side effects occurring after palliative 3D-CRT for cervico-thoracic spinal metastases. All patients receiving palliative 3D-CRT at Jean Bernard Center from January 2013 to December 2014 for spinal metastases between the 5th cervical vertebra (C5) and the 12th thoracic vertebra (T12) were eligible. Three-dimensional conformal RT was delivered by a linear accelerator (CLINAC, Varian). Premedication to prevent digestive toxicities was not used. Adverse events (“esophagitis” and “nausea and/or vomiting”) were evaluated according to the NCI-CTCae (version 4). From January 2013 to December 2014, 128 patients met the study criteria. The median age was 68.6 years [31.8; 88.6]. Most patients (84.4%) received 30 Gy in 10 fractions. The median overall time of treatment was 13 days [3–33]. Forty patients (31.3%) suffered from grade ≥ 2 of “esophagitis” (35 grade 2 (27.4%) and 5 grade 3 (3.9%)). Eight patients (6.3%) suffered from grade ≥ 2 of “nausea and/or vomiting” (6 grade 2 (4.7%), 1 grade 3 (0.8%), and 1 grade 4 (0.8%)). The high incidence of moderate to severe digestive toxicities after palliative 3D-CRT for cervico-thoracic spinal metastases led to consider static or dynamic intensity-modulated radiation therapy (IMRT) to reduce the dose to organ at risk (the esophagus and stomach). Dosimetric studies and implementation in the clinic should be the next steps. |
| Databáze: | OpenAIRE |
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