A Comparison of Gastrointestinal Toxicities between Intensity-Modulated Radiotherapy and Three-Dimensional Conformal Radiotherapy for Pancreatic Cancer

이경주; 윤홍인; Moon Jae Chung; Jeong Youp Park; Seungmin Bang; Seung-woo Park; Jin Sil Seong; Si Young Song

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자료유형: 학술저널

저자정보: 이경주 윤홍인 Moon Jae Chung Jeong Youp Park Seungmin Bang Seung-woo Park Jin Sil Seong Si Young Song

저널정보: 거트앤리버 발행위원회 Gut and Liver Gut and Liver 제10권 제2호

발행연도: 2016.1

수록면: 303 - 309 (7page)

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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.

#Gastrointestinal toxicities #Chemoradiotherapy #Pancreatic neoplasms #Endoscopy #Radiotherapy #intensitymodulated

참고문헌 (33)

참고문헌 신청

Huguet F / 2009 / Chemoradiotherapy in the management of locally advanced pancreatic carcinoma: a qualitative systematic review / J Clin Oncol 27:2269~2277

Loehrer PJ Sr / 2011 / Gemcitabine alone versus gemcitabine plus radiotherapy in patients with locally advanced pancreatic cancer: an Eastern Cooperative Oncology Group trial / J Clin Oncol 29:4105~4112

Evans DB / 2008 / Preoperative gemcitabine-based chemoradiation for patients with resectable adenocarcinoma of the pancreatic head / J Clin Oncol 26:3496~3502

Le Scodan R / 2009 / Preoperative chemoradiation in potentially resectable pancreatic adenocarcinoma: feasibility, treatment effect evaluation and prognostic factors, analysis of the SFRO-FFCD 9704 trial and literature review / Ann Oncol 20:1387~1396

Brunner TB / 2010 / The role of radiotherapy in multimodal treatment of pancreatic carcinoma / Radiat Oncol 5:64

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