Predictors of severe gastrointestinal toxicity after external beam radiotherapy and interstitial brachytherapy for advanced or recurrent gynecologic malignancies

Kasibhatla, Mohit S.; Clough, Robert; Montana, Gustavo S.; Oleson, James R.; Light, K.; Steffey, Beverly; Jones, Ellen L.

doi:10.1016/j.ijrobp.2005.12.008

Cited by 45 publications

(26 citation statements)

References 30 publications

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“…[16][17][18] Former studies about radiation-induced bowel toxicity reported that approximately 2-9% of the patients developed radiation enterocolitis requiring surgery when total doses of 45-55 Gy pelvic radiotherapy was used with conventional fractionations. [5,19,20] Thus, it has been suggested in recent years that the dose is important concerning bowel complication and that the EBRT dose should not exceed 54 Gy. [3] In this study, the mean dose was 45 Gy, five patients received pelvic radiotherapy over 45 Gy and the maximum dose was 54 Gy.…”

Section: Discussionmentioning

confidence: 99%

“…Other risk factors are total radiation dose, hypertension, diabetes mellitus, and age. [3][4][5][6] In the last decade, laparoscopic surgery has been more preferred rather than abdominal surgery in the field of gynecological oncology, which is the result of advances in surgical techniques. When compared with laparotomy, it is thought to reduce the risk of developing adhesions and radiation-induced bowel toxicity due to be minimally invasive.…”

Section: Simulationmentioning

confidence: 99%

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

Dağdelen¹

2020

TJ Oncol

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Simulationmentioning

confidence: 99%

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

Dağdelen¹

2020

TJ Oncol

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“…Bowel fistulae in the irradiated woman present a significant challenge. They occur in up to 8% of women undergoing single or combined‐modality treatment for cervical carcinoma 9 . Because of the avascular nature of the tissue, simple closure is ineffective.…”

Section: The Gastrointestinal Systemmentioning

confidence: 99%

Treatment‐related morbidity in gynaecological cancers

Hadwin

Petts

Olaitan

2010

The Obstetric & Gynaecologis

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Key content:• The National Cancer Survivorship Initiative recognises that all treatment modalities in cancer have potential long-term physical and psychosocial implications for patients. • Prediction and early recognition can prevent or minimise treatment-related morbidity in gynaecological cancer. Learning objectives:• To introduce the concept of survivorship as an essential component of gynaecological oncology care. • To understand the range of problems that women encounter following cancer treatment and the need for a multidisciplinary approach. Ethical issues:• Informed counselling prior to treatment includes a description of potential long-term morbidity, which may contribute to decision making.

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“…Therapy-related factors include radiation dose, volume of bowel irradiated, time-dose-fractionation parameters, and use of concomitant chemotherapy or biotherapy. Previous abdominal surgery or intraabdominal infections increase the risk of radiation enteropathy [25,26,27 ]. Specific comorbidities, for example, inflammatory bowel disease [28], diabetes [29], vascular disease [30], scleroderma [31], and tobacco smoking [32] predispose patients to complications after radiation therapy.…”

Section: Incidence and Prevalencementioning

confidence: 99%

Radiation damage to the gastrointestinal tract: mechanisms, diagnosis, and management

Hauer‐Jensen

Wang

Boerma

et al. 2007

Current Opinion in Supportive &Amp; Palliative Care

123

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The risk of injury to the intestine is dose limiting during abdominal and pelvic radiation therapy. Delayed bowel toxicity is difficult to manage and adversely impacts the quality of life of cancer survivors. More than 200,000 patients per year receive abdominal or pelvic radiation therapy, and the estimated number of cancer survivors with postradiation intestinal dysfunction is 1.5-2 million. Worthwhile progress towards reducing toxicity of radiation therapy has been made by dose-sculpting treatment techniques. Approaches derived from an improved understanding of the pathophysiology of bowel injury, however, will result in further advances. This article discusses the mechanisms of radiation-induced bowel toxicity and reviews current principles in diagnosis and management.

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Predictors of severe gastrointestinal toxicity after external beam radiotherapy and interstitial brachytherapy for advanced or recurrent gynecologic malignancies

Cited by 45 publications

References 30 publications

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

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

Treatment‐related morbidity in gynaecological cancers

Radiation damage to the gastrointestinal tract: mechanisms, diagnosis, and management

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