The Journal of Practical Medicine >
Analysis of dosimetric parameters of acute radiation enteritis in cervical cancer patients treated with concurrent chemoradiotherapy
Received date: 2023-10-07
Online published: 2024-03-26
Objective To explore the correlation between intestinal dose and acute radiation enteritis (ARE) in patients with cervical cancer received concurrent chemoradiotherapy, and optimize the dose limit of intestinal tissue. Methods 158 cervical cancer patients received concurrent chemoradiotherapy from 2014 to 2019 were selected in this study. According to CTCAE 5.0, patients with ARE ≥ grade 2 were classified as ARE ≥ grade 2 group, otherwise classified as ARE < grade 2 group. The intestinal dosimetric parameters of the two groups were recorded from the dose volume histogram. The correlation between ARE ≥ grade 2 and intestinal dosimetric parameters were analyzed using univariate and multivariate logistic regression. Results Among the 158 cervical cancer patients received concurrent chemoradiotherapy, 26 cases had grade 2 or above ARE (16.46%). The incidence of ARE ≥ grade 2 in patients with malnutrition and three-dimensional conformal radiotherapy was significantly higher than that in patients with well-nourished and intensity modulated radiotherapy (P < 0.05). The bowelbag V5, V40 and the rectal V50 of cervical cancer patients with ARE ≥ grade 2 were significantly higher than those with ARE < grade 2 (P < 0.05). ROC curves showed that bowelbag V5 and V40 were significant predictors of ARE ≥ grade 2 (AUC > 0.7, P < 0.05). Conclusions For patients with cervical cancer received concurrent chemoradiotherapy, the dose of bowelbag V5 and V40 should be considered to rationally optimize the dose of bowelbag in the radiotherapy plan, so as to reduce the incidence of ARE ≥ grade 2.
Jing HU , Xu WANG , Xiaoqin GONG , Rui LING , Tao YOU , Chunhua DAI , Ye TIAN , Fei. CHEN . Analysis of dosimetric parameters of acute radiation enteritis in cervical cancer patients treated with concurrent chemoradiotherapy[J]. The Journal of Practical Medicine, 2024 , 40(5) : 672 -676 . DOI: 10.3969/j.issn.1006-5725.2024.05.014
| 1 | VORDERMARK D. Radiotherapy of Cervical Cancer[J]. Oncol Res Treat, 2016, 39(9): 516-520. doi:10.1159/000448902 |
| 2 | LOGE L, FLORESCU C, ALVES A, et al. Radiation enteritis: Diagnostic and therapeutic issues[J]. J Visc Surg, 2020, 157(6): 475-485. doi:10.1016/j.jviscsurg.2020.08.012 |
| 3 | FAN J, LIN B, FAN M, et al. Research progress on the mechanism of radiation enteritis[J]. Front Oncol, 2022, 12: 888962. doi:10.3389/fonc.2022.888962 |
| 4 | NIE H, PAN J, AN F, et al. Comprehensive Analysis of Serum Metabolites Profiles in Acute Radiation Enteritis Rats by Untargeted Metabolomics[J]. Tohoku J Exp Med, 2021, 255(3): 257-265. doi:10.1620/tjem.255.257 |
| 5 | REHAILIA-BLANCHARD A, HE M Y, RANCOULE C, et al. Physiopathology and pharmacological perspectives in the treatment of radiation enteritis[J]. Cancer Radiother, 2019, 23(3): 240-247. doi:10.1016/j.canrad.2018.05.010 |
| 6 | ASHMAN J B, ZELEFSKY M J, HUNT M S, et al. Whole pelvic radiotherapy for prostate cancer using 3D conformal and intensity-modulated radiotherapy[J]. Int J Radiat Oncol Biol Phys, 2005, 63(3): 765-771. doi:10.1016/j.ijrobp.2005.02.050 |
| 7 | LI Q, CHEN J, ZHU B, et al. Dose Volume Effect of Acute Diarrhea in Post-Operative Radiation for Gynecologic Cancer[J]. Rev Invest Clin, 2017, 69(6): 329-335. doi:10.24875/ric.17002373 |
| 8 | SEPPENWOOLDE Y, MAJERCAKOVA K, BUSCHMANN M, et al. Early morbidity and dose-volume effects in definitive radiochemotherapy for locally advanced cervical cancer: a prospective cohort study covering modern treatment techniques[J]. Strahlenther Onkol, 2021, 197(6): 505-519. doi:10.1007/s00066-021-01781-6 |
| 9 | 李洲宇, 杨兴龙, 蔡展拓, 等.重组人表皮生长因子外用溶液联合蒙脱石散保留灌肠预防宫颈癌患者放射性直肠炎的临床观察[J].实用医学杂志, 2022, 38(17): 2221-2225. doi:10.3969/j.issn.1006-5725.2022.17.019 |
| 10 | WENZEL H H B, OLTHOF E P, BEKKERS R L M, et al. Primary or adjuvant chemoradiotherapy for cervical cancer with intraoperative lymph node metastasis-A review[J]. Cancer Treat Rev, 2022, 102: 102311. doi:10.1016/j.ctrv.2021.102311 |
| 11 | 彭清河, 陈锴, 李珺芸, 等.局部晚期宫颈癌同步放化疗疗效和预后分析[J].中华肿瘤防治杂志, 2022, 29(20): 1500-1507. |
| 12 | CHARGARI C, PEIGNAUX K, ESCANDE A, et al. Radiotherapy of cervical cancer[J]. Cancer Radiother, 2022, 26(1/2): 298-308. doi:10.1016/j.canrad.2021.11.009 |
| 13 | YANG X, WANG J, LIN L, et al. Concomitant chemoradiotherapy versus pure radiotherapy in locally advanced cervical cancer: a retrospective analysis of complications and clinical outcome[J]. Eur J Gynaecol Oncol, 2016, 37(4):499-503. |
| 14 | ZHANG K, WANG H, WANG Z, et al. Intensity-modulated radiation therapy (IMRT)-based concurrent chemoradiotherapy (CCRT) with Endostar in patients with pelvic locoregional recurrence of cervical cancer: Results from a hospital in the Qinghai-Tibet Plateau[J]. Medicine (Baltimore), 2020, 99: e21966. doi:10.1097/md.0000000000021966 |
| 15 | MA C Y, ZHAO J, GAN G H, et al. Establishment of a prediction model for severe acute radiation enteritis associated with cervical cancer chemoradiotherapy[J]. World J Gastroenterol, 2023, 29(8): 1344-1358. doi:10.3748/wjg.v29.i8.1344 |
| 16 | KUMAR A, TUDU R, SINGH R, et al. Dose-volume analysis of acute gastrointestinal complications in cervical cancer undergoing definitive concurrent chemoradiotherapy[J]. J Cancer Res Ther, 2021, 17(1): 170-173. doi:10.4103/jcrt.jcrt_313_19 |
| 17 | NAIK A, GURJAR O P, GUPTA K L, et al. Comparison of dosimetric parameters and acute toxicity of intensity-modulated and three-dimensional radiotherapy in patients with cervix carcinoma: A randomized prospective study[J]. Cancer Radiother Actions, 2016, 20(5): 370-376. doi:10.1016/j.canrad.2016.05.011 |
| 18 | LIU Y M, NI L Q, WANG S S, et al. Outcome and prognostic factors in cervical cancer patients treated with surgery and concurrent chemoradiotherapy: a retrospective study[J]. World J Surg Oncol, 2018, 16(1): 18. doi:10.1186/s12957-017-1307-0 |
| 19 | BULLOCK A F, GREENLEY S L, MCKENZIE G A G, et al. Relationship between markers of malnutrition and clinical outcomes in older adults with cancer: systematic review, narrative synthesis and meta-analysis[J]. Eur J Clin Nutr, 2020, 74(11): 1519-1535. doi:10.1038/s41430-020-0629-0 |
| 20 | WANG J, HU G. Nomogram to Predict Radiation Enteritis in Cervical Squamous Cell Carcinoma[J]. Cancer Manag Res, 2022, 14: 3303-3311. doi:10.2147/cmar.s383909 |
| 21 | MUELLER C, COMPHER C, ELLEN D M, et al. A.S.P.E.N. clinical guidelines: Nutrition screening, assessment, and intervention in adults[J]. JPEN J Parenter Enteral Nutr, 2011, 35(1): 16-24. doi:10.1177/0148607110389335 |
| 22 | YEUNG A R, PUGH S L, KLOPP A H, et al. Improvement in Patient-Reported Outcomes With Intensity-Modulated Radiotherapy (RT) Compared With Standard RT: A Report From the NRG Oncology RTOG 1203 Study[J]. J Clin Oncol, 2020, 38(15): 1685-1692. doi:10.1200/jco.19.02381 |
| 23 | 陈默,黄荣,蒋军.调强放射治疗条件下根治性宫颈癌的长期生存报道[J].实用医学杂志, 2020, 36(20): 2810-2814. doi:10.3969/j.issn.1006-5725.2020.20.013 |
| 24 | GUY J B, FALK A T, AUBERDIAC P, et al. Dosimetric study of volumetric arc modulation with RapidArc and intensity-modulated radiotherapy in patients with cervical cancer and comparison with 3-dimensional conformal technique for definitive radiotherapy in patients with cervical cancer[J]. Med Dosim, 2016, 41(1): 9-14. doi:10.1016/j.meddos.2015.06.002 |
| 25 | GAY H A, BARTHOLD H J, O'MEARA E, et al. Pelvic normal tissue contouring guidelines for radiation therapy: a Radiation Therapy Oncology Group consensus panel atlas[J]. Int J Radiat Oncol Biol Phys, 2012, 83(3): e353-62. doi:10.1016/j.ijrobp.2012.01.023 |
| 26 | KOZAK M M, KOENIG J L, VON EYBEN R, et al. Less Than Whole Uterus Irradiation for Locally Advanced Cervical Cancer Maintains Locoregional Control and Decreases Radiation Dose to Bowel[J]. Pract Radiat Oncol, 2019, 9(2): e164-e171. doi:10.1016/j.prro.2018.10.009 |
/
| 〈 |
|
〉 |