Acute toxicity with intensity modulated radiotherapy versus 3-dimensional conformal radiotherapy during preoperative chemoradiation for locally advanced rectal cancer

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• 作者：Shu Y. Ng^a ; Kathryn L Colborn^b ; Lajhem Cambridge^a ; Carla Hajj^a ; T. Jonathan Yang^a ; Abraham J. Wu^a ; Karyn A. Goodman^c ; ^{karyn.goodman@ucdenver.edu}
• 关键词：Locally advanced rectal cancer ; Toxicity ; Pelvic radiotherapy ; Pre-operative chemoradiation ; Intensity modulated radiotherapy
• 刊名：Radiotherapy and Oncology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：121
• 期：2
• 页码：252-257
• 全文大小：332 K
• 卷排序：121

文摘

We examined acute toxicity profiles and outcomes among rectal cancer patients treated with pre-operative chemoradiation using intensity modulated radiotherapy (IMRT) or 3-dimensional conformal radiotherapy (3DCRT) to identify predictive clinical factors associated with increased acute toxicity.Material and methodsWe retrospectively reviewed records of 301 consecutive rectal cancer patients treated with pre-operative chemotherapy and radiotherapy (median dose 5000 cGy) at our institution between 2007 and 2014.ResultsOf the 301 patients, 203 (67.4%) were treated with IMRT and 98 (32.6%) with 3DCRT. Significantly more patients experienced ⩾grade 2 diarrhea in the 3DCRT group compared to the IMRT group (22% vs 10%, p = 0.004), and those who received 3DCRT had 2.7 times greater odds of a higher diarrhea score than those on IMRT, even after adjusting for patient characteristics and chemotherapy (OR 2.71, p = 0.01) Fewer patients experienced grade 2 genitourinary toxicity in the IMRT group (6% vs 13% 3DCRT, p = 0.04) and there was a trend toward decreased grade 2 proctitis in the IMRT group (22% vs 32% 3DCRT, p = 0.07). Patients over the age of 55 had 45% lower odds of proctitis than patients younger than 55.ConclusionThe use of IMRT significantly reduced grade ⩾2 diarrhea and GU toxicity during chemoradiation. Younger patients were more likely to report grade 2 or higher proctitis.