Combined Adjuvant Radiochemotherapy With IMRT/XELOX Improves Outcome With Low Renal Toxicity in Gastric Cancer

Boda-Heggemann, Judit; Hofheinz, Ralf–Dieter; Weiß, Christel; Mennemeyer, P.; Sabine, K.; Hermes, Petra; Wertz, H.; Post, Stefan; Massner, B.; Hieber, U.; Hochhaus, Andreas; Wenz, Frederik; Lohr, Frank

doi:10.1016/j.ijrobp.2008.12.036

Cited by 35 publications

(29 citation statements)

References 42 publications

(62 reference statements)

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“…Therefore, in the current study, V20 and Dmean parameters were selected to evaluate the irradiated kidneys. The most important finding in our research is that, IMRT had significantly lowered the meanV20 value of the right kidney by 15% (P=0.001) and of the left kidney by 9% (P=0.01), which was consistent to previous retrospective studies 18,19,21 . In addition, we observed the decrease of the mean irradiated volume of both kidneys by IMRT technique but such decrease was not significant, subsequently; the Dmean values were similar in both techniques.…”

Section: Discussionsupporting

confidence: 92%

“…Two published studies, from the University of Heidelberg, compared the dose distribution of different planning modalities, and observed reduction of the median dose to the left kidney and the doses to V30 and V60 to the kidneys and liver by IMRT [17][18][19] . Some investigators reported that the clinical gains yielded by IMRT are not superior to 3D-CRT in terms of OS, RFS and toxicity in gastric cancer patients [20][21][22][23] . The rationale of the present study is to determine, on a planning basis, which radiation techniques can eliminate the delivering radiation dose to OAR.…”

Section: Discussionmentioning

confidence: 99%

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Dosimetric Comparative Study of Static Gantry IMRT and 3D Conformal Radiotherapy for Organ at Risk in Adjuvant Therapy of Gastric Cancer

Darwish

2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Background: Despite the benefits of postoperative radiotherapy for gastric cancer patients after publishing the results of the Intergroup 0116 (INT-0116) study, there are still the concerns of radiation-induced toxicity. Aim: To determine the radiation technique that can eliminate the dose of radiation to the organ at risk (OAR) in patients postoperatively treated for gastric cancer with three-dimensional conformal radiotherapy (3D-CRT) or intensitymodulated radiotherapy (IMRT) using dosimetric analysis. Methods: A total of 22 computerized radiation plans were reviewed. Dosimetric values for 3DCRT and IMRT technique were calculated. The following dosimetric parameters were compared for the planned target volume (PTV); the homogeneity index, maximal and minimal doses, the volumes of PTV received 95 % and 107 % of the prescribed dose. In addition, the mean dose and dose volume histogram (DVH) for the OAR as, V20 for each kidney, V30 for the liver, maximum dose (Dmax) for D1% of the spinal cord and V40 to the heart . Results: The 3D-CRT and IMRT achieved comparable PTV coverage. However, IMRT was associated with a highly significant decrease in the mean V20 value of the right kidney by 15% (P=0.001) and left kidney by 9% (P=0.01). The IMRT significantly improved sparing of the mean irradiated volume and the V30 of the liver by 12% (P=0.01) and by 10% (P=0.02) respectively compared with 3D-CRT. On the other hand, the dosimetric parameters for the spinal cord and heart were comparable for the IMRT and 3D-CRT plans. Conclusion: In gastric cancer patients receiving postoperative radiotherapy, IMRT provided better protection for the liver and kidneys when compared to 3D-CRT.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Dosimetric Comparative Study of Static Gantry IMRT and 3D Conformal Radiotherapy for Organ at Risk in Adjuvant Therapy of Gastric Cancer

Darwish

2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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“…Milano et al (14) also reported that the IMRT reduced the liver V30 (63.6 vs. 18.9%, P= 0.010) and right kidney V20 (20.9 vs. 11.6%, P= 0.027) compared with 2/3-field 3DCRT. Boda-Heggemann et al (22) observed that the V30 of the left and right kidneys was 26.8 vs. 19.5%, respectively (P= 0.0015) when investigating 27 patients who received concurrent CRT with 3DCRT. A study conducted by Stanford University (23) also indicated that IMRT led to a reduction of the liver V30 from 28 to 16.1% compared with 3DCRT.…”

Section: Discussionmentioning

confidence: 98%

A retrospective study on intensity-modulated radiation therapy combined with chemotherapy after D2 radical surgery for gastric carcinoma

Luo

Zhang

Zhao

et al. 2016

Molecular and Clinical Oncology

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Abstract. In order to investigate the clinical value of different chemotherapies, the efficacy of intensity-modulated radiation therapy with concurrent chemotherapy following D2 radical surgery for gastric carcinoma was evaluated in this study. A total of 102 patients who underwent D2 radical surgery for gastric carcinoma followed by concurrent chemoradiotherapy (CRT) between January, 2008 and March, 2012, were selected. The 5/7 field intensity-modulated radiation therapy was used, with a planning target volume dose of 45 Gy in 25 fractions over 5 weeks. Among these patients, 45 were administered 400 mg̸m 2 ̸day fluorouracil and 20 mg̸m 2 ̸day tetrahydrofurfuryl alcohol through intravenous infusion 4 days before and 3 days after the radiotherapy (F-CRT group), while 57 patients received 825 mg/m 2 capecitabine orally twice a day (C-CRT group). The 3-year overall and the disease-free survival rates were 75.5 and 70.5%, respectively. The overall 3-year survival rates of the F-CRT and C-CRT groups were 72.2 and 78.5% (P>0.05), respectively, and the 3-year disease-free survival rates were 67.7 and 72.8% (P>0.05), respectively. No significant differences were observed between the two groups. However, during the concurrent CRT, significant differences were found in the incidence of grade 1-2 haematological toxicity between the F-CRT and C-CRT groups (73.3 vs. 50.9%, respectively; χ 2 =5.320, P= 0.021). Significant differences were also found in the incidence of grade 1-2 gastrointestinal reactions between the two groups (77.8 vs. 57.9%, respectively; χ 2 = 4.474, P= 0.034). Therefore, intensity-modulated radiation therapy combined with concurrent chemotherapy following D2 radical surgery for gastric cancer was found to be safe and effective.In addition, radiotherapy was better tolerated and more likely to be completed using C-CRT rather than F-CRT.

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“…Interestingly, this difference was not solely attributable to either the variability in chemotherapy treatment regimen or the radiation technique. 86 Three important considerations regarding implementation of advanced radiation techniques are variability in target delineation, anticipation of respiratory motion, and experience of the treating center. To spare neighboring organs at risk, IMRT treatment plans create sharp dose gradients at the edges of treatment targets.…”

Section: Role Of Intensity Modulated Radiation Treatmentmentioning

confidence: 99%

Gastric Cancer

Lawson¹,

Sicklick²,

Fanta³

2011

Current Problems in Cancer

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Combined Adjuvant Radiochemotherapy With IMRT/XELOX Improves Outcome With Low Renal Toxicity in Gastric Cancer

Cited by 35 publications

References 42 publications

Dosimetric Comparative Study of Static Gantry IMRT and 3D Conformal Radiotherapy for Organ at Risk in Adjuvant Therapy of Gastric Cancer

Dosimetric Comparative Study of Static Gantry IMRT and 3D Conformal Radiotherapy for Organ at Risk in Adjuvant Therapy of Gastric Cancer

A retrospective study on intensity-modulated radiation therapy combined with chemotherapy after D2 radical surgery for gastric carcinoma

Gastric Cancer

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