Predictors of severe gastrointestinal toxicity after external beam radiotherapy and interstitial brachytherapy for advanced or recurrent gynecologic malignancies
| Autor: | Beverley A. Steffey, Robert W. Clough, James R. Oleson, Ellen L. Jones, Gustavo S. Montana, Kim L. Light, Mohit Kasibhatla |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Vaginal Neoplasms Genital Neoplasms Female medicine.medical_treatment Brachytherapy Uterine Cervical Neoplasms Rectum medicine Carcinoma Humans Radiology Nuclear Medicine and imaging External beam radiotherapy Radiation Injuries Aged Retrospective Studies Aged 80 and over Univariate analysis Radiation business.industry Rectovaginal Fistula Retrospective cohort study Middle Aged medicine.disease Endometrial Neoplasms Surgery Bowel obstruction medicine.anatomical_structure Oncology Rectovaginal fistula Carcinoma Squamous Cell Female Radiology Neoplasm Recurrence Local business |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 65:398-403 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2005.12.008 |
| Popis: | The aim of this retrospective review of patients with gynecologic malignancies treated with external beam radiotherapy (EBRT) and interstitial brachytherapy was to determine the rate of Gradeor =2 rectovaginal fistula and Gradeor =4 small bowel obstruction as defined by the National Cancer Institute Common Toxicity Criteria for Adverse Events, version 3.0.Thirty-six patients with primary and recurrent gynecologic cancers were treated with EBRT and interstitial brachytherapy. Median doses to tumor, bladder, and rectum were 75 Gy, 61 Gy, and 61 Gy, respectively. A univariate analysis was performed to identify variables that correlated with toxicity.At median follow-up of 19 months, the 3-year risk of small bowel obstruction was 6%. Those patients with prior abdomino-pelvic surgery who received EBRT with antero-posterior fields had higher rates of obstruction than patients without prior abdomino-pelvic surgery or those who received EBRT with four fields (50% vs. 0%, p0.0001). The 3-year risk of rectovaginal fistula was 18% and was significantly higher in patients who received76 Gy to the rectum compared with those who receivedor =76 Gy (100% vs. 7%, p = 0.009).Patients treated with EBRT and interstitial brachytherapy after abdomino-pelvic surgery should receive EBRT with four fields and the cumulative rectal dose should beor =76 Gy. |
| Databáze: | OpenAIRE |
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