Severe intestinal toxicity after stereotactic ablative radiotherapy for abdominopelvic malignancies

Bae, Sun Hyun; Kim, Misook; Kim, So Young; Jang, Won Il; Cho, Chul Koo; Yoo, Hyun Jung; Kim, Kum Bae; Lee, Dong Han; Han, Chul Ju; Yang, Ki Young; Kim, Sang Bum

doi:10.1007/s00384-013-1717-6

Cited by 22 publications

(17 citation statements)

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“…Three patients had pre-SBRT gastroduodenal ulcer confirmed by esophagogastroduodenoscopy. We previously performed studies about severe gastroduodenal and intestinal toxicity after SBRT using 3 fractions for abdominopelvic malignancies and reported their results [ 37 , 38 ]. In the study about gastroduodenal toxicity, we suggested that Dmax is a valuable predictor of severe gastroduodenal tocivity.…”

Section: Discussionmentioning

confidence: 99%

High-dose stereotactic body radiotherapy correlates increased local control and overall survival in patients with inoperable hepatocellular carcinoma

et al. 2013

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BackgroundRecent studies using stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC) have reported high tumor response and local control. However, the optimal SBRT dose remains unknown, and it is still not clear whether a dose response relationship for local control (LC) and overall survival (OS) exist or not. We performed this study to determine whether a dose response relationship for LC and OS is observed in SBRT for inoperable HCC.MethodsBetween 2003 and 2011, 108 patients with HCC were treated with SBRT. All patients were unsuitable for surgery or local ablation and had incomplete response to transarterial chemoembolization. Eighty-two patients with a longest tumor diameter (LD) less than or equal to 7.0 cm who were treated with 3-fraction SBRT and were analyzed. This cohort comprised 74 Child-Turcotte-Pugh (CTP) class A patients and 8 CTP class B7 patients. The median LD was 3.0 cm (range, 1.0–7.0 cm), and the median dose was 51 Gy (range, 33–60 Gy).ResultsLC and OS rates at 2 years after SBRT were 87% and 63%, respectively, with a median follow-up duration of 30 months for all patients. The 2-year LC/OS rates for patients treated with doses of > 54, 45–54, and < 45 Gy were 100/71, 78/64, and 64%/30%, respectively (p = .009/p < .001). Multivariate analysis revealed that the SBRT dose (p = .005) and Barcelona Clinic Liver Cancer stage (p = .015) were significant prognostic factors for OS. Correlation analysis revealed a positive linear relationship between the SBRT dose and LC (p = .006, R = .899)/OS (p = .002, R = .940) at 2 years. Based on the tumor-control probability model, a dose of 54.8 Gy provides 2-year LC with a 90% probability. Five patients experienced grade 3 or higher gastrointestinal toxicity, and 6 had deteriorating of CTP score by greater than or equal to 2 within 3 months of SBRT.ConclusionsThis study demonstrated a dose response relationship for LC and OS with SBRT for HCC. Higher LC rates resulting from an increased dose may translate into survival benefits for patients with HCC.

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Section: Discussionmentioning

confidence: 99%

High-dose stereotactic body radiotherapy correlates increased local control and overall survival in patients with inoperable hepatocellular carcinoma

et al. 2013

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“…Unfortunately, because a prospective study controlling DVH parameters has not been undertaken until now, there is no definite conclusion about gastrointestinal dose tolerance. Based on extensive experience in administering SBRT to tumors located in the abdominopelvic site using three fractions, we have recently suggested dose constraints for the gastroduodenum and intestine . A D max of 35 Gy was associated with a 5% increase in the probability of the development of severe gastrointestinal toxicity.…”

Section: Discussionmentioning

confidence: 99%

Salvage stereotactic body radiotherapy for locally recurrent uterine cervix cancer at the pelvic sidewall: Feasibility and complication

Seo

Kim

Yoo

et al. 2014

Asia-Pac J Clin Oncol

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“…In the clinic, higher dosed hRT is sometimes applied on consecutive days. However, it is often applied every other day or only twice per week, mostly because of safety concerns to achieve better normal tissue protection and to avoid treatment-induced adverse effects (14)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Abscopal Effects With Hypofractionated Schedules Extending Into the Effector Phase of the Tumor-Specific T-Cell Response

Zhang

Niedermann

2018

International Journal of Radiation Oncology*Biology*Physics

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Our data suggest that combination therapy with hRT schedules extending into the period during which treatment-induced T cells infiltrate the irradiated tumor can provoke local and systemic antitumor effects similar to those with therapy using shorter schedules, if the regional lymph nodes supply sufficient tumor-specific T cells. This has implications for planning clinical RT/immune checkpoint blockade trials.

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Severe intestinal toxicity after stereotactic ablative radiotherapy for abdominopelvic malignancies

Abstract: Following three fractions of SABR, V(25) is a valuable predictor of severe IT. And SABR would be conducted with a treatment interval of at least 48 h if possible.

Cited by 22 publications

References 20 publications

High-dose stereotactic body radiotherapy correlates increased local control and overall survival in patients with inoperable hepatocellular carcinoma

High-dose stereotactic body radiotherapy correlates increased local control and overall survival in patients with inoperable hepatocellular carcinoma

Salvage stereotactic body radiotherapy for locally recurrent uterine cervix cancer at the pelvic sidewall: Feasibility and complication

Abscopal Effects With Hypofractionated Schedules Extending Into the Effector Phase of the Tumor-Specific T-Cell Response

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