Late gastrointestinal tissue effects after hypofractionated radiation therapy of the pancreas

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Adnan,Patel,Mukund,Weinberg,Benjamin,Verma,Vivek,L R.,Gay,Hiram A. Elhammali (Creator)

Institution

East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Abstract: Background: To consolidate literature reports of serious late gastrointestinal toxicities after hypofractionatedradiation treatment of pancreatic cancer and attempt to derive normal tissue complication probability (NTCP)parameters using the Lyman-Kutcher-Burman model.Methods: Published reports of late grade 3 or greater gastrointestinal toxicity after hypofractionated treatment ofpancreatic cancer were reviewed. The biologically equivalent dose in 1.8 Gy fractions was calculated using the EQDmodel. NTCP parameters were calculated using the LKB model assuming 1--5 % of the normal tissue volume wasexposed to the prescription dose with a/β ratios of 3 or 4.Results: A total of 16 human studies were examined encompassing a total of 1160 patients. Toxicities consisted ofulcers, hemorrhages, obstructions, strictures, and perforations. Non-hemorrhagic and non-perforated ulcers occurredat a rate of 9.1 % and were the most commonly reported toxicity. Derived NTCP parameter ranges were as follows:n = 0.38--0.63, m = 0.48--0.49, and TD50 = 35--95 Gy. Regression analysis showed that among various studycharacteristics, dose was the only significant predictor of toxicity.Conclusions: Published gastrointestinal toxicity reports after hypofractionated radiotherapy for pancreatic cancerwere compiled. Median dose was predictive of late grade ≥ 3 gastrointestinal toxicity. Preliminary NTCP parameterswere derived for multiple volume constraints.

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Language: English

Date: 2015

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