Acute small bowel toxicity and preoperative chemoradiotherapy for rectal cancer: Investigating dose–volume relationships and role for inverse planning

Tho, Lye Mun; Glegg, M.; Paterson, J R; Yap, Christina; MacLeod, A.; McCabe, Marcia; McDonald, A. C.

doi:10.1016/j.ijrobp.2006.05.005

Cited by 130 publications

(104 citation statements)

References 39 publications

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“…Furthermore, a dose-volume relationship has been recognized between the severity of toxicity caused by diarrhea and the irradiated small bowel volume at all dose levels in patients preoperatively treated with chemoradiation for rectal cancer. 21 The irradiated small bowel volume thresholds to envisage severe gastrointestinal toxicity is unidentified, even though a strong association subsists between the level of acute small bowel toxicity and the small bowel volume getting 15 Gy (V15). 22 The advent of innovative and sophisticated irradiation methods, such as intensity modulated radiation therapy (IMRT), signifies a stunning progress in the planning and delivery of external beam radiation.…”

Section: Dosimetric Resultsmentioning

confidence: 99%

Conformal radiotherapy in rectal cancer: a dosimetric review

Simson

2016

Int J Res Med Sci

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It has been a decade since preoperative chemoradiotherapy is the standard of care in the treatment of rectal cancer. Even though the main picture remains the same, there were many refinements that happened in delivery of chemotherapy, radiotherapy and, of course, surgical skills. Technical advancements in radiotherapy helped us to precisely deliver radiotherapy with minimal side effects. Nevertheless, none of these have been studied in detail to assess the effectiveness and bad effects. It has been noted that modern radiotherapy techniques even though reduces high doses to the critical organ doses, but increases the volume of normal tissues receiving low dose radiation, the adverse effects of the same need to be assessed. There hadn’t been any consensus whether to treat with 3D Conformal Radiotherapy (3DCRT) or Intensity Modulated Radiotherapy (IMRT). This article reviews various dosimetric parameters of various techniques of radiotherapy presently being used in our department which includes conventional, 3DCRT and IMRT.

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Section: Dosimetric Resultsmentioning

confidence: 99%

Conformal radiotherapy in rectal cancer: a dosimetric review

Simson

2016

Int J Res Med Sci

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“…Nonetheless, further studies should be carried on to include in the data base other volumes than rectum for GI complication prediction [21], to use doseÁwall histograms or normalized histograms taking into account the fractionation effect [22]. Presumably, with these modifications the EUD model could be more predictive than a single doseÁvolume point.…”

Section: Conclusion and Discussionmentioning

confidence: 99%

Clinical comparative study of dose–volume and equivalent uniform dose based predictions in post radiotherapy acute complications

Boulé

Fuentes

Roselló³

et al. 2009

Acta Oncologica

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“…A dose of <40 Gy was the acceptable limit on the small bowel. 7 Additionally, up to 150 cm 3 of small bowel is considered by radiation oncologists as a safe volume to receive radiation. We used this small-bowel volume and again compared the amount of radiation in both groups.…”

Section: Methodsmentioning

confidence: 99%

Does transperitoneal minimally invasive radical prostatectomy increase the amount of small bowel receiving salvage radiation?

Luz¹,

Pra²,

Tu³

et al. 2013

CUAJ

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Introduction: Transperitoneal minimally invasive radical prostatectomy (MIRP) has become first choice for several urologists and patients dealing with localized prostate cancer. We evaluate the effect of postoperative radiation on the small bowel in patients who underwent extraperitoneal open versus transperitoneal MIRP. Methods:We reviewed all patients who received postoperative radiation from 2006 to 2010. Planning target volume (PTV) and surrounding organs, including the small bowel, were delineated. The presence of the small bowel in PTV and its volume in receiving each dose level were analyzed. Results: A total of 122 patients were included: 26 underwent MIRP and 96 underwent open prostatectomy. The median age of patients was 66 years, with median body mass index 27 kg/m 2 . The total PTV dose was 66 Gy, with the minimum and maximum doses received by the small bowel 0.4 and 66.4 Gy, respectively. The maximum volume of small bowel that received the safe limit of 40 Gy was 569 cm 3 . Of the 26 patients who underwent MIRP, 12 (46%) had small bowel identified inside the PTV compared to 57 (59%) among patients who underwent open prostatectomy (p = 0.228). The mean volume of the small bowel receiving 40 Gy was 26 and 67 cm 3 in open and MIRP groups, respectively (p = 0.006); the incidence of acute complications was the same in both groups. Conclusions: Higher volumes of the small bowel are subjected to significant radiation after MIRP procedures compared to open procedures; however, we could not demonstrate any impact on acute complications. Whether there is a difference in late complications remains to be evaluated.

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Acute small bowel toxicity and preoperative chemoradiotherapy for rectal cancer: Investigating dose–volume relationships and role for inverse planning

Cited by 130 publications

References 39 publications

Conformal radiotherapy in rectal cancer: a dosimetric review

Conformal radiotherapy in rectal cancer: a dosimetric review

Clinical comparative study of dose–volume and equivalent uniform dose based predictions in post radiotherapy acute complications

Does transperitoneal minimally invasive radical prostatectomy increase the amount of small bowel receiving salvage radiation?

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