Is there any Relation between the Type of Surgery and Radiation Induced Non-rectal Bowel Toxicity in Patients with Gynecologic Cancer Receiving Adjuvant Radiotherapy?

Abstract

Dosimetric and clinical comparison of the effects of surgical type on the risk of developing radiationinduced non-rectal bowel toxicity in patients with gynecologic cancer who have received adjuvant radiotherapy. METHODS 36 patients who meet study criteria were retrospectively evaluated and classified as laparoscopy (group 1) and open surgery (group 2). Intestinal volumes that received a 10% range of total radiotherapy dose at 10% (V 10%) to 100% (V 100%) and dosimetric data (V40-45 Gy, Dmax.) were obtained from the dosevolume histogram. The toxicities were graded acute and late according to Radiation Therapy Oncology Group (RTOG) scoring. RESULTS The median follow-up was 55 months in group 1 and 37 months in group 2. Grade 2 acute bowel toxicity was observed in seven patients (38.9%) in group 1 and three patients (16.7%) in group 2. One patient in group 1 was diagnosed with ileus as late toxicity requiring surgery.There was no significant difference between the groups concerning surgical type and toxicity development. CONCLUSION A similar risk of developing radiation-induced non-rectal bowel toxicity in patients who underwent laparoscopic or open surgery has been demonstrated in this study. However, due to the small number of patients, prospective studies with large sample sizes are needed for the correct interpretation.