Intensity-modulated radiotherapy reduces gastrointestinal toxicity in pelvic radiation therapy with moderate dose

• Published in: PloS one 2017-08, Vol.12 (8), p.e0183339
• Main Authors: Kwak, Yoo-Kang, Lee, Sea-Won, Kay, Chul Seung, Park, Hee Hyun
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biology and Life Sciences; Boundaries; Cancer; Cancer therapies; Cervical cancer; Chemotherapy; Clinical outcomes; Drug dosages; Endometrial Neoplasms - radiotherapy; Female; Gastrointestinal Diseases - etiology; Gastrointestinal Tract - radiation effects; Group dynamics; Gynecology; Hospitals; Humans; Incidence; Lymphatic system; Male; Medicine; Medicine and Health Sciences; Middle Aged; Multivariate analysis; NMR; Nuclear magnetic resonance; Oncology; Patients; Pelvis - radiation effects; Physical Sciences; Prostate cancer; Quality; Quality of Life; Radiation; Radiation dosage; Radiation Injuries - etiology; Radiation therapy; Radiotherapy Dosage; Radiotherapy, Intensity-Modulated - adverse effects; Radiotherapy, Intensity-Modulated - methods; Research and Analysis Methods; Retrospective Studies; Toxicity; Treatment Outcome; Urinary Bladder Neoplasms - radiotherapy; Uterine Cervical Neoplasms - radiotherapy
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0183339

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.