Stomach and duodenum dose–volume constraints for locally advanced pancreatic cancer patients treated in 15 fractions in combination with chemotherapy

Broggi, S.; Passoni, P.; Tiberio, Paolo; Cicchetti, A.; Cattaneo, Giovanni Mauro; Longobardi, B.; Mori, Martina; Reni, Michele; Slim, N.; Vecchio, Antonella Del; Muzio, N.G. Di; Fiorino, C.

doi:10.3389/fonc.2022.983984

Cited by 2 publications

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References 39 publications

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“…Therefore, it is very necessary to study the gastrointestinal radiation injuries and their affecting factors dose parameters and clinical factors etc, according to the recent clinical reports, are related to gastrointestinal toxicity of pancreatic cancer treated after radiotherapy. [ 11 ] As for other tumors, such as lung cancer, the parameters of dose-volume histogram (DVH) can be used to predict the toxicity of normal tissues [ 12 ] ; there are also available data to quantify the risks of gastrointestinal toxicity for pancreatic cancer treated with radiotherapy, [ 13 , 14 ] but gastrointestinal toxicity was not evaluated by gastroscopy. In this study, we carried out gastroscopy for pancreatic cancer patients before and after radiotherapy with an aim to describe gastrointestinal mucosa injury on an objective basis and explore whether the gastrointestinal DVH parameters can be used to accurately predict gastrointestinal mucosa injury, thus to provide dosage reference to prevent gastrointestinal injury for pancreatic cancer patients treated after radiotherapy.…”

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confidence: 99%

Gastroscopic observation and dose-volume histogram parameter study on gastrointestinal mucous injury for pancreatic cancer treated with TOMO

Wei,

Han,

Zhang

et al. 2024

Medicine

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To explore the relationships between gastrointestinal radiation injuries of pancreatic cancer patients treated with TOMO and dose-volume histogram parameters prospectively. Seventy patients with pancreatic cancer who underwent TOMO were enrolled in this prospective study from February 2015 to May 2020. The clinical and dose-volume histogram parameters of the patients were collected. The optimal dose parameters for gastrointestinal radiation ulcers were confirmed based on the receiver operating characteristic curve (ROC) and the area below the ROC curve. Acute gastrointestinal tract toxic and side effect and injury grading correlation analyzed by Kruskal-Wallis rank sum test. Gastrointestinal injury often occurs during radiotherapy for pancreatic cancer, as observed using gastroscopy. The main adverse reactions were radioactive gastrointestinal inflammation (58.5%), radioactive gastrointestinal ulcers (41.4%), active bleeding (10%), newly-developed gastric retention (8.6%), and gastric varices (5.7%). As for the stomach, Dmean and V10 were related to radiation ulcer injury. ROC curve indicated that for stomach a Dmean of 13.39 Gy (area under ROC curves = 0.74, P = .048) and a V10 of 72.21% (area = 0.74, P = .048) was the tolerated dose for the injury of stomach radiation ulcer. As for duodenum, aV20 and aV25 are related to radiation ulcer injury. ROC curve indicated that aV20 of 22.82 cm3 (area = 0.68, P = .025) and aV25 of 32.04 cm3 (area = 0.66, P < .047) was the tolerated dose for the injury of duodenum radiation ulcer. The acute gastrointestinal tract toxic and side effects have no significant correlation with injury grading under gastroscope. Dmean > 13.39 Gy and V10 > 72.21% were the key dosimetric indices for predicting radiation-induced gastric ulcer, and aV20 > 22.82 cm3 and aV25 > 32.04 cm3 were for duodenal. Gastrointestinal reactions cannot be used as an overall basis for the diagnosis of gastrointestinal injury, and gastroscopy is recommended as a review item after radiotherapy.

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