A Comparison of Gastrointestinal Toxicities between Intensity-Modulated Radiotherapy and Three-Dimensional Conformal Radiotherapy for Pancreatic Cancer.
- Author:
Kyong Joo LEE
1
;
Hong In YOON
;
Moon Jae CHUNG
;
Jeong Youp PARK
;
Seungmin BANG
;
Seung woo PARK
;
Jin Sil SEONG
;
Si Young SONG
Author Information
- Publication Type:Comparative Study ; Original Article
- Keywords: Gastrointestinal toxicities; Chemoradiotherapy; Pancreatic neoplasms; Endoscopy; Radiotherapy; intensity-modulated
- MeSH: Aged; Female; Follow-Up Studies; Gastrointestinal Diseases/*etiology; Humans; Male; Middle Aged; Pancreatic Neoplasms/*radiotherapy; Prospective Studies; Radiation Injuries/*complications; Radiotherapy, Conformal/*adverse effects; Radiotherapy, Intensity-Modulated/*adverse effects; Risk Factors
- From:Gut and Liver 2016;10(2):303-309
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Concurrent chemoradiotherapy (CCRT) is considered the treatment option for locally advanced pancreatic cancer, but accompanying gastrointestinal toxicities are the most common complication. With the introduction of three-dimensional conformal radiotherapy (3-D CRT) and intensity-modulated radiotherapy (IMRT), CCRT-related adverse events are expected to diminish. Here, we evaluated the benefits of radiation modalities by comparing gastrointestinal toxicities between 3-D CRT and IMRT. METHODS: Patients who received CCRT between July 2010 and June 2012 in Severance Hospital, Yonsei University College of Medicine, were enrolled prospectively. The patients underwent upper endoscopy before and 1 month after CCRT. RESULTS: A total of 84 patients were enrolled during the study period. The radiotherapy modalities delivered included 3D-CRT (n=40) and IMRT (n=44). The median follow-up period from the start of CCRT was 10.6 months (range, 3.8 to 29.9 months). The symptoms of dyspepsia, nausea/vomiting, and diarrhea did not differ between the groups. Upper endoscopy revealed significantly more gastroduodenal ulcers in the 3-D CRT group (p=0.003). The modality of radiotherapy (3D-CRT; odds ratio [OR], 11.67; p=0.011) and tumor location (body of pancreas; OR, 11.06; p=0.009) were risk factors for gastrointestinal toxicities. CONCLUSIONS: IMRT is associated with significantly fewer gastroduodenal injuries among patients treated with CCRT for pancreatic cancer.
