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KMID : 1188320160100020303
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Gut and Liver
2016 Volume.10 No. 2 p.303 ~ p.309
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A Comparison of Gastrointestinal Toxicities between Intensity-Modulated Radiotherapy and Three-Dimensional Conformal Radiotherapy for Pancreatic Cancer
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Lee Kyong-Joo
Yoon Hong-In
Chung Moon-Jae
Park Jeong-Youp
Bang Seung-Min
Park Seung-Woo
Seong Jin-Sil
Song Si-Young
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Abstract
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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
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KEYWORD
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Gastrointestinal toxicities, Chemoradiotherapy, Pancreatic neoplasms, Endoscopy, Radiotherapy, intensity-modulated
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