Dose-response relationships of the sigmoid for urgency syndrome after gynecological radiotherapy

Alevronta, Eleftheria; Skokic, Viktor; Wilderäng, Ulrica; Dunberger, Gail; Sjöberg, Fei; Bull, Cecilia; Bergmark, Karin; Jörnsten, Rebecka; Steineck, Gunnar

doi:10.1080/0284186x.2018.1468082

Cited by 5 publications

(7 citation statements)

References 25 publications

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“…NTCP of rectum and sigmoid were calculated based on LKB model. The model parameters were taken from Eleftheria's study [27] that enrolled a database of 2-to 14-year follow-up. The present study shows that NTCP values for rectum and sigmoid in the proton plan are significantly lower in SRO plans, which is consistent with previous studies [ref].…”

Section: Discussionmentioning

confidence: 99%

“…However, there are significant uncertainties in the NTCP model and its associated parameters, which might result in the scoring complications, disparity in endpoints, and dosimetric changes. In current studies, biology models have described the steep dose-response relationships established for rectum and sigmoid from large groups of gynecological cancer survivors for a 2-to 14-year follow-up [27]. In Eleftheria's study [27], large groups and long history follow-up in gynecological cancer, make the model parameters best suited for their data, with parameters of the LKB model are show from Table 3.…”

Section: Normal Tissue Complication Probability (Ntcp)mentioning

confidence: 99%

“…In current studies, biology models have described the steep dose-response relationships established for rectum and sigmoid from large groups of gynecological cancer survivors for a 2-to 14-year follow-up [27]. In Eleftheria's study [27], large groups and long history follow-up in gynecological cancer, make the model parameters best suited for their data, with parameters of the LKB model are show from Table 3. In our study, the LKB model for NTCP calculation was performed for rectum and sigmoid in the TRO and SRO plans, respectively.…”

Section: Normal Tissue Complication Probability (Ntcp)mentioning

confidence: 99%

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Evaluation of plan quality and robustness of IMPT and helical IMRT for cervical cancer

Shang

Wang

et al. 2020

Radiat Oncol

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Background: Both plan quality and robustness were investigated through comparing some dosimetric metrics between intensity modulated proton therapy (IMPT) and helical tomotherapy based intensity modulated radiotherapy (IMRT) for cervical cancer. Methods: Both a spot-scanning robust (SRO) IMPT plan and a helical tomotherapy robust (TRO) IMRT plan were generated for each of 18 patients. In order to evaluate the quality of nominal plans without dose perturbations, planning scores (PS) on clinical target volume (CTV) and five organs at risk (OARs) based on clinical experience, and normal tissue complication probabilities (NTCP) of rectum and sigmoid were calculated based on Lyman-Kutcher-Burman (LKB) model. Dose volume histogram bands width (DVHBW) were calculated in 28 perturbed scenarios to evaluate plan robustness. Results: Compared with TRO, the average scores of SRO nominal plans were higher in target metrics [V 46.8Gy , V 50Gy , Conformity and Homogeneity](16.5 vs. 15.1), and in OARs metrics (60.9 vs. 53.3), including bladder [V 35 ,V 45 , D mean , D 2cc ], rectum [V 40 ,V 45 ,D 2cc ,D max ], bowel [V 35 ,V 40 ,V 45 , D max ], sigmoid [V 40 ,D max ] and femoral heads [V 30 ,D max ]. Meanwhile, NTCP calculation showed that the toxicities of rectum and sigmoid in SRO were lower than those in TRO (rectum: 2.8% vs. 4.8%, p < 0.05; sigmoid: 5.2% vs. 5.7%, p < 0.05). DVHBW in target coverage for the SRO plan was smaller than that for the TRO plan (0.6% vs. 2.1%), which means that the SRO plan generated a more robust plan in target. Conclusion: Better CTV coverage and OAR Sparing were obtained in SRO nominal plan. Based on NTCP calculation, SRO was expected to allow a small reduction in rectal toxicity. Furthermore, SRO generated a more robust plan in CTV target coverage.

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Section: Discussionmentioning

confidence: 99%

Section: Normal Tissue Complication Probability (Ntcp)mentioning

confidence: 99%

Section: Normal Tissue Complication Probability (Ntcp)mentioning

confidence: 99%

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Evaluation of plan quality and robustness of IMPT and helical IMRT for cervical cancer

Shang

Wang

et al. 2020

Radiat Oncol

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“…Indeed, a limited number of previous studies in gynaecological cancers support this hypothesis [22e24]. Alevronta et al [22] studied radiation-induced urgency in 98 gynaecological cancer survivors and found that the sigmoid colon had a steeper dose-response relationship and a higher AUC than the small bowel and rectum. Chopra et al [23] investigated dosimetric predictors for late gastrointestinal toxicity in 71 cervical cancer patients undergoing postoperative radiotherapy.…”

Section: Discussionmentioning

confidence: 97%

Dosimetric and Clinical Predictors for Acute and Late Gastrointestinal Toxicity Following Chemoradiotherapy of Locally Advanced Anal Cancer

et al. 2022

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Aims: To analyse dosimetric and clinical predictors for acute and late gastrointestinal toxicity following chemoradiotherapy of anal cancer. Materials and methods: Consecutive patients with locally advanced (T2 !4 cm e T4 or Nþ) anal cancer were selected from an institutional database (n ¼ 114). All received intensity-modulated radiotherapy with concomitant 5-fluorouracil and mitomycin C. Gastrointestinal toxicity was retrospectively graded according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 and bowel cavity, small bowel and large bowel were contoured. Dosimetric and clinical variables were tested for associations with acute grade !3 gastrointestinal toxicity and late grade !2 gastrointestinal toxicity using the ManneWhitney test, area under receiver operating characteristic curve (AUC) and logistic regression. Results: The median follow-up was 40 months. Acute grade !3 gastrointestinal toxicity was seen in 51 (44.7%) of the patients; late grade !2 gastrointestinal toxicity was seen in 36 of the patients (39.6% of 91 patients with >1 year recurrence-free follow-up). Bowel cavity V30Gy was the best dosimetric predictor for acute gastrointestinal toxicity (AUC 0.633; P ¼ 0.02). Large bowel V20Gy was the best dosimetric predictor for late gastrointestinal toxicity (AUC 0.698; P ¼ 0.001) but showed no association with acute gastrointestinal toxicity. In multivariate logistic regression, increasing age was significantly associated with acute gastrointestinal toxicity; smoking and large bowel V20Gy were significantly associated with late gastrointestinal toxicity. Patients who experienced acute grade !3 gastrointestinal toxicity were not at an increased risk of late grade !2 gastrointestinal toxicity (odds ratio 1.3; P ¼ 0.55). Conclusions: Factors of importance for acute and late gastrointestinal toxicity were not the same. Bowel cavity V30Gy is a good metric to use for the prediction of acute gastrointestinal toxicity, but the results of our study indicate that individual large and small bowel loops need to be contoured for better prediction of late gastrointestinal toxicity. The role of the large bowel as an important organ at risk for late gastrointestinal toxicity merits further research.

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“…Narrowing of the bowel lumen and eventual obstruction can result from transmural injury of the bowel wall which lead to a progressive vasculitis, thrombosis with variable degrees of ischemia and necrosis (7,8) .Symptoms of radiation enteropathy may appear early i.e within hours of the first treatment session; or delay to months or years after ending of the treatment. Most patients usually experience acute symptoms about 2-3 weeks into the treatment and resolve in 2-6 months (9) . Symptoms may be self-limited and mild need principally symptomatic therapy but this is not a reflection to degree of mucosal damage and the correlation between the severity of damage in mucosa and the severity of symptoms seems to be poor (10) .…”

confidence: 99%

Early gastrointestinal adverse events of pelvic radiotherapy in Iraqi patients

Mohammad¹,

Al-Askari²,

Hassan³

et al. 2019

ATMPH

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Radiotherapy is used with or without chemotherapy for treatment of malignancies in pelvic organs. This radiation can cause functional effects on GIT organs. Radiation enteropathy continues to be a major obstacle to the radio curability of abdominal and pelvic tumors despite the advances in the field of radiation oncology. Aim of the study: is to identify the early adverse events of GIT toxicity due to pelvic radiotherapy and identifying risk factors. Patients and methods: A cross-sectional study that included 30 patients (12 males and 18 females) their age ranged from 25-73 years who attended to the Al-Amal national hospital for cancer management in Baghdad, Iraq in 2018, those patients already diagnosed with different types of cancer (Uterine cancer, cervical cancer, vulvar cancer, rectal cancer, anal cancer and prostate cancer) and they need pelvic radiotherapy during their course of management. All parameters estimated depended on history which based on a questionnaire about the symptoms that related to the GIT radiation toxicity including (anorexia, nausea, vomiting, diarrhea, pain, constipation, and bleeding per rectum) according to Common Terminology Criteria for Adverse Events (CTCAE) v3.0; from National Cancer Institute. Results:80 % of patients had symptoms associated with GIT toxicity. The most common early adverse events was pain (56.6%) and the least one is the blood in stool (0%). Most symptoms are of Grade 1 (70%) and the remaining are of Grade 2 (30%), Age and gender of patient are not associated with increasing risk of GIT toxicity. Incidence of the radiotherapy adverse events and their grades were increased in the conventional radiotherapy treatment modality as compared to the conformal radiotherapy modality (3D). Conclusion: symptoms associated with GIT toxicity are common after pelvic radiotherapy mostly of low grade. Pain is the most common presenting symptom and the least one is blood in stool. Radiotherapy treatment modality is important factor to avoid or decrease the risk of GIT toxicity, conformal radiotherapy is better than conventional radiotherapy.

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Dose-response relationships of the sigmoid for urgency syndrome after gynecological radiotherapy

Cited by 5 publications

References 25 publications

Evaluation of plan quality and robustness of IMPT and helical IMRT for cervical cancer

Evaluation of plan quality and robustness of IMPT and helical IMRT for cervical cancer

Dosimetric and Clinical Predictors for Acute and Late Gastrointestinal Toxicity Following Chemoradiotherapy of Locally Advanced Anal Cancer

Early gastrointestinal adverse events of pelvic radiotherapy in Iraqi patients

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