- 作者：Ronald C. Chen ; M.D. ; M.P.H.&lowast ; ; &Dagger ; ; § ; ; Harvey J. Mamon ; M.D. ; Ph.D.§ ; ; Marek Ancukiewicz ; Ph.D.&lowast ; ; Joseph H. Killoran ; Ph.D.§ ; ; Elizabeth M. Crowley ; M.S.&lowast ; ; Lawrence S. Blaszkowsky ; M.D.&dagger ; ; Jennifer Y. Wo ; M.D.&lowast ; ; David P. Ryan ; M.D.&dagger ; ; Theodore S. Hong ; M.D.&lowast ; ; tshong1@partners.org
- 关键词：Rectal cancer ; Chemoradiation therapy ; Patient-reported outcomes ; Quality of life ; Dose&ndash ; volume histogram
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 期刊代码：136_03603016
- 类别：med
- 出版时间：15 July, 2012
- 卷：83
- 期：4
- 页码：e513-e517
- 文件大小：205 K
Purpose
Research on patient-reported outcomes (PROs) in rectal cancer is limited. We examined whether dose-volume parameters of the small bowel and large bowel were associated with patient-reported gastrointestinal (GI) symptoms during 5-fluorouracil (5-FU)-based chemoradiation treatment for rectal cancer.Methods and Materials
66 patients treated at the Brigham & Women鈥檚 Hospital or Massachusetts General Hospital between 2006 and 2008 were included. Weekly during treatment, patients completed a questionnaire assessing severity of diarrhea, urgency, pain, cramping, mucus, and tenesmus. The association between dosimetric parameters and changes in overall GI symptoms from baseline through treatment was examined by using Spearman鈥檚 correlation. Potential associations between these parameters and individual GI symptoms were also explored.
Results
The amount of small bowel receiving at least 15 Gy (V15) was significantly associated with acute symptoms (p = 0.01), and other dosimetric parameters ranging from V5 to V45 also trended toward association. For the large bowel, correlations between dosimetric parameters and overall GI symptoms at the higher dose levels from V25 to V45 did not reach statistical significance (p = 0.1), and a significant association was seen with rectal pain from V15 to V45 (p < 0.01). Other individual symptoms did not correlate with small bowel or large bowel dosimetric parameters.
Conclusions
The results of this study using PROs are consistent with prior studies with physician-assessed acute toxicity, and they identify small bowel V15 as an important predictor of acute GI symptoms during 5-FU-based chemoradiation treatment. A better understanding of the relationship between radiation dosimetric parameters and PROs may allow physicians to improve radiation planning to optimize patient outcomes.