Abstract
Radiation-induced emesis (RIE) is usually noted during abdominal-pelvic radiotherapy. In gynecological malignancies, it is usually noted in para-aortic but not whole-pelvic irradiation. Irradiated small bowel (SB) may be associated with RIE. The significance of SB dosimetry remains unclear. Dosimetric and non-dosimetric factors were evaluated and correlated with RIE in 45 patients with gynecological malignancies undergoing extended-field radiotherapy (EFRT) (median 45 Gy) from 2006 to 2021. Early-onset RIE (within 72 h after the first fraction of EFRT) was noted in 10 of 12 RIE patients. RIE was significantly associated with the SB mean dose. The RIE rates were 58.3% and 15.2% (p = 0.007) in patients with a low (<63%) and high (≥63%) SB mean dose. Logistic regression revealed that the SB mean dose remained the independent factor of overall RIE (p = 0.049) and early-onset RIE (p = 0.014). Therefore, constraint of the SB mean dose limited to less than 63% of the prescribed dose is suggested to decrease RIE.
Highlights
Radiation-induced emesis (RIE) is a common side effect in radiotherapy for abdominal malignancies
Patients who met the following conditions were eligible in this study: (i) cervical or endometrial cancer confirmed by histology; (ii) clinical FIGO stage IB2-IVa cervical cancer or pathologically stage IIIC cervical cancer or stage IIIC endometrial cancer; (iii) no prior radiotherapy; (iv) age ≥20 years old and performance status of the Eastern Cooperative Oncology Group (ECOG) 0–2; (v) adequate bone marrow, renal and liver function
The onset of vomiting usually appeared within 72 h after the first fraction of radiotherapy in 10 patients
Summary
Radiation-induced emesis (RIE) is a common side effect in radiotherapy for abdominal malignancies. The incidence is around 40% [1]. Quality of life is always affected due to characteristic of early onset and the impairment of food intake [1]. The upper abdomen is a more frequent site than the pelvis for the development of RIE [2,3]. The prevention and management of RIE can avoid treatment interruption of radiotherapy. Dosimetric study for RIE may be helpful for RIE prevention. There is no dosimetric study about RIE in patients with abdominal malignancies. The aim of the current study is to identify dosimetric factors of RIE in these patients
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