Damage assessment in gastric cancer treatment with adjuvant radiochemotherapy: calculation of the NTCP’s from the differential HDV of the organs at risk

Wals, Amadeo; Contreras, Jorge; Macías, J.; Ruiz, Inmaculada Fortes; Rivas, Daniel; González, Pedro; Herruzo, Ismael

doi:10.1007/bf02664938

Cited by 6 publications

(6 citation statements)

References 12 publications

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“…However, these advese effects may cause problems in the future if long-term survival is achieved. [21][22][23][24] Moreover, for patients with advanced or recurrent gastric cancer which was deemed difficult to treat surgically, we believe that the survival benefit is greater than any long-term adverse effects. Mean survival period of patients with poor general condition was 12 ± 7.68 months (range 3-23 months) and the adverse effects of chemoradiotherapy and the progression of the cancer was not a cause of death.…”

Section: Discussionmentioning

confidence: 98%

Usefulness of chemoradiotherapy for inoperable gastric cancer

Taki

Hoya

Watanabe

et al. 2017

annals

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INTRODUCTION Radiotherapy is not commonly used for the treatment of gastric cancer in Japan, where surgery is the standard local treatment. We report the results of chemoradiotherapy in patients with advanced or recurrent gastric cancer which was deemed difficult to treat surgically. METHODS Twenty-one patients with gastric cancer (including sixteen with advanced/recurrent gastric cancer and five with poor general condition) underwent chemo-radiotherapy, for whom the therapeutic efficacy, toxicity and survival period were analysed. RESULTS The tumour response to chemoradiotherapy was categorised as complete, partial, stable or progressive in 5, 9, 3, and 4 patients, respectively, with an overall response rate of 67%. No serious complications such as gastrointestinal perforation or bleeding occurred, and no cardiac, hepatic or renal dysfunction developed during the follow-up period. The mean survival time was 19.8 months (range, 3-51 months). One patient died of another disease, 18 died of primary cancer and the cause of death was unknown in 2 patients. CONCLUSIONS Chemoradiotherapy appears to be an effective treatment for localised gastric cancer without distant metastases, but further studies are needed to determine the indications for chemoradiotherapy and late adverse effects, as well as the chemotherapy regimens to be used.

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Section: Discussionmentioning

confidence: 98%

Usefulness of chemoradiotherapy for inoperable gastric cancer

Taki

Hoya

Watanabe

et al. 2017

annals

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“…Though the liver doses and liver volume receiving 30 Gy were higher on 3D, they were still within the tolerance limits. Wals et al (2006) assessed NTCP and TCP in 29 patients underwent post-operative chemoradiotherapy. Fourteen of these 20 patients underwent 2D and the remaining 15 patients underwent 3D planning and these two patient groups were compared for TCP and NTCP.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 2-Dimensional and 3-Dimensional Conformal Treatment Plans in Gastric Cancer Radiotherapy

Adaş¹,

Andrieu²,

Hiçsönmez³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Asian Pac J Cancer Prev, 15 (17), 7401-7405 IntroductionGastric cancer is the fourth common cancer worldwide and is the second leading cause of death from cancer (Qurieshi et al., 2011;Zare et al., 2013;Calik et al., 2014;Oh et al., 2014). At present complete resection is the only curative therapy (Yu et al., 2013). 25-40% of the patients are suitable for curative surgery. Postoperative local recurrence is an important issue; 38% loco regional recurrence and 28% peritoneal spread are observed post operatively (Czito et al., 2013). Intergroup 0116 study (INT 0116) demonstrated significance of post-operative RT in gastric cancer. Following a 10 year-follow-up period, a significant benefit was observed in relapse free survival and in overall survival (Smalley et al., 2012). Based on the results of this study, post-operative chemoradiotherapy became a standard procedure in stage IB-IV M0 patients. Because of the critical organs in the vicinity, which are low in tolerance, planning of RT in gastric cancer is important (Czito et al., 2013). In this study 2D and 3D therapy plannings were compared in terms of dosimetric parameters. The aim was to assess the field efficiency of the 2D plan and to evaluate the 3D plan in terms of both its coverage of the target volume and its effect to decrease the normal tissue doses.

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“…20,21 The model parameters used for calculation of pancreatic adenocarcinoma cell death and the NTCP for failure of kidneys, gastric bleeding, striction or fistula of the small intestine and liver failure were given in Appendix 3. [22][23][24][25][26][27][28] Statistical significance was determined applying the paired sample t-test at the 2-tailed, 0.05 significance level.…”

Section: Comparison Metricsmentioning

confidence: 99%

A novel X‐Ray and γ‐Ray combination strategy for potential dose escalation in patients with locally advanced pancreatic cancer

et al. 2022

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Background Treatment of locally advanced pancreatic cancer (LAPC) has long been calling for advances in technology of radiotherapy. Patients who received radiotherapy still had high risks of local recurrence, while suffering from gastrointestinal side effects. Based on the inherent characteristics of the x‐ray and γ‐Ray radiation techniques, here we proposed and investigated an unexplored radiation therapy. Purpose To investigate the potential clinical benefit of a novel x‐ray and γ‐Ray combination radiation technique in patients with LAPC. Methods Retrospective intensity‐modulated radiotherapy (IMRT) treatment plans of 10 LAPC patients were randomly selected to compare with dual‐modality plans. The prescribed dose to PGTV was 60.2 Gy. The PGTV dose was further escalated in dual‐modality plan while maintaining clinically tolerable dose to organs at risk (OARs). Dosimetric comparisons were made and analyzed for three treatment plans (tomotherapy, standard dual‐modality plan, escalated dual‐modality plan) to assess the ability to increase dose to target volume while minimizing dose in adjacent OARs. Finally, radiobiological models were utilized for comparison. Results All strategies resulted in dosimetrically acceptable plans. Dual‐modality plans were present with similar conformity index (CI) and significantly lower gradient index (GI) compared with tomotherapy (3.64 ± 0.37 vs. 4.14 ± 0.61, p = 0.002; 3.64 ± 0.42 vs. 4.14 ± 0.61, p = 0.003). Dmean of PGTV (65.46 ± 3.13 vs. 61.56 ± 1.00, p = 0.009; 77.98 ± 5.86 vs. 61.56 ± 1.00, p < 0.001) and PCTV (55.04 ± 2.14 vs. 53.93 ± 1.67, p = 0.016; 58.24 ± 3.24 vs. 53.93 ± 1.67, p = 0.001) were significantly higher, while Dmean of the stomach was reduced in both dual‐modality plans (17.98 ± 10.23 vs. 19.34 ± 9.75, p = 0.024; 17.62 ± 9.92 vs. 19.34 ± 9.75, p = 0.040). The lower V30Gy in the liver (4.83 ± 5.87 vs. 6.23 ± 6.68, p = 0.015; 4.90 ± 5.93 vs. 6.23 ± 6.68, p = 0.016) and lower V45Gy of the small intestine (3.35 ± 3.30 vs. 4.06 ± 3.87, p = 0.052) were found in dual‐modality plans. Meanwhile, radiobiological models demonstrated higher probability of tumor control (29.27% ± 9.61% vs. 18.34% ± 4.70%, p < 0.001; 44.67% ± 18.16% vs. 18.34% ± 4.70%, p = 0.001) and lower probability of small intestine complication (2.16% ± 2.30% vs. 1.25% ± 2.72%, p = 0.048) in favor of dual‐modality strategy. Conclusions A novel dual‐modality strategy of x‐ray and γ‐Ray combination radiation appears reliable for target dose escalation and normal tissue dose reduction. This strategy might be beneficial for local tumor control and the protection of normal organs in patients with LAPC.

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Damage assessment in gastric cancer treatment with adjuvant radiochemotherapy: calculation of the NTCP’s from the differential HDV of the organs at risk

Cited by 6 publications

References 12 publications

Usefulness of chemoradiotherapy for inoperable gastric cancer

Usefulness of chemoradiotherapy for inoperable gastric cancer

Comparison of 2-Dimensional and 3-Dimensional Conformal Treatment Plans in Gastric Cancer Radiotherapy

A novel X‐Ray and γ‐Ray combination strategy for potential dose escalation in patients with locally advanced pancreatic cancer

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