Abstract
This retrospective study was performed to evaluate and compare gastrointestinal (GI) toxicities caused by conventional radiotherapy (cRT) and intensity modulated radiotherapy (IMRT) in 136 cancer patients treated with pelvic radiotherapy (RT) with moderate radiation dose in a single institution. A matched-pair analysis of the two groups was performed; each group included 68 patients. Conventional RT was delivered using the four-field box technique and IMRT was delivered with helical tomotherapy. The median daily dose was 1.8 Gy and the median total dose was 50.4 Gy (range 25.2–56 Gy). Primary end point was GI toxicity during and after RT. Secondary end point was factors that affect toxicity. Patients treated with IMRT had lower incidence of grade ≥ 2 acute GI toxicity compared to the patients treated with cRT (p = 0.003). The difference remained significant in multivariate analysis (p = 0.01). The incidence of chronic GI toxicity was not statistically different between the two groups, but the cRT group had higher incidence of grade 3 chronic GI toxicity. Based on our results, IMRT can reduce GI toxicity compared to cRT in the treatment of pelvic radiotherapy even with moderate radiation dose and this will enhance patients’ quality of life and treatment compliance.
Highlights
Indications for radiotherapy are gradually increasing and radiotherapy is applied in various cancer treatments
This study demonstrated significantly lower rate of grade ! 2 GI toxicities in the intensity modulated radiotherapy (IMRT) group than the conventional radiotherapy (cRT) group with statistical significance (p = 0.003; OR = 2.97; 95% CI, 1.48–5.98) and the significance was retained after controlling other factors (p = 0.01; OR = 3.39; 95% CI, 1.20–6.43)
This study was performed to compare the acute and chronic GI toxicities in 136 patients who were treated with IMRT or cRT to the pelvis with moderate radiation dose
Summary
Indications for radiotherapy are gradually increasing and radiotherapy is applied in various cancer treatments. Radiotherapy plays a major role in the curative and adjuvant treatment of cancer that develops in the pelvis. In uterine cervical cancer, treatment outcomes after radiotherapy or surgery are comparable in early staged disease [1] and in cases of locally advanced diseases, chemoradiotherapy is the mainstay of treatment [2,3,4]. Radiotherapy is beneficial to eradicate the cancer cells, damage to the adjacent normal tissues is inevitable. When delivering radiation to pelvis, gastrointestinal complications are always of first concern due to its proximity to the target volumes and since the tolerable radiation dose of bowel is lower than the sufficient treatment dose to the cancer cells [5]
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