Acute toxicity with intensity modulated radiotherapy versus 3-dimensional conformal radiotherapy during preoperative chemoradiation for locally advanced rectal cancer Journal Article


Authors: Ng, S. Y.; Colborn, K. L.; Cambridge, L.; Hajj, C.; Yang, T. J.; Wu, A. J.; Goodman, K. A.
Article Title: Acute toxicity with intensity modulated radiotherapy versus 3-dimensional conformal radiotherapy during preoperative chemoradiation for locally advanced rectal cancer
Abstract: Background and purpose We examined acute toxicity profiles and outcomes among rectal cancer patients treated with pre-operative chemoradiation using intensity modulated radiotherapy (IMRT) or 3-dimensional conformal radiotherapy (3DCRT) to identify predictive clinical factors associated with increased acute toxicity. Material and methods We retrospectively reviewed records of 301 consecutive rectal cancer patients treated with pre-operative chemotherapy and radiotherapy (median dose 5000 cGy) at our institution between 2007 and 2014. Results Of the 301 patients, 203 (67.4%) were treated with IMRT and 98 (32.6%) with 3DCRT. Significantly more patients experienced ⩾grade 2 diarrhea in the 3DCRT group compared to the IMRT group (22% vs 10%, p = 0.004), and those who received 3DCRT had 2.7 times greater odds of a higher diarrhea score than those on IMRT, even after adjusting for patient characteristics and chemotherapy (OR 2.71, p = 0.01) Fewer patients experienced grade 2 genitourinary toxicity in the IMRT group (6% vs 13% 3DCRT, p = 0.04) and there was a trend toward decreased grade 2 proctitis in the IMRT group (22% vs 32% 3DCRT, p = 0.07). Patients over the age of 55 had 45% lower odds of proctitis than patients younger than 55. Conclusion The use of IMRT significantly reduced grade ⩾2 diarrhea and GU toxicity during chemoradiation. Younger patients were more likely to report grade 2 or higher proctitis. © 2016 Elsevier Ireland Ltd
Keywords: toxicity; pelvic radiotherapy; intensity modulated radiotherapy; locally advanced rectal cancer; pre-operative chemoradiation
Journal Title: Radiotherapy and Oncology
Volume: 121
Issue: 2
ISSN: 0167-8140
Publisher: Elsevier Inc.  
Date Published: 2016-11-01
Start Page: 252
End Page: 257
Language: English
DOI: 10.1016/j.radonc.2016.09.010
PROVIDER: scopus
PUBMED: 27751605
DOI/URL:
Notes: Article -- Export Date: 3 January 2017 -- Source: Scopus
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MSK Authors
  1. Abraham Jing-Ching Wu
    369 Wu
  2. Carla Hajj
    133 Hajj
  3. Jonathan T Yang
    158 Yang
  4. Shu Yi Ng
    7 Ng