Prospective study on late renal toxicity following postoperative chemoradiotherapy in gastric cancer.

2.50
Hdl Handle:
http://hdl.handle.net/10541/71039
Title:
Prospective study on late renal toxicity following postoperative chemoradiotherapy in gastric cancer.
Authors:
Jansen, Edwin P M; Saunders, Mark P; Boot, Henk; Oppedijk, Vera; Dubbelman, Ria; Porritt, Bridget; Cats, Annemieke; Stroom, Joep; Valdés Olmos, Renato; Bartelink, Harry; Verheij, Marcel
Abstract:
PURPOSE: Postoperative chemoradiotherapy in gastric cancer improves locoregional control and survival. Reports on late toxicity, however, have been scarce thus far. Because renal toxicity is one of the most serious late complications in upper abdominal radiotherapy, we prospectively analyzed kidney function in patients who underwent postoperative chemoradiotherapy for gastric cancer. PATIENTS AND METHODS: In 44 patients, Tc99m-thiatide renography was performed before and at regular intervals after postoperative chemoradiotherapy. The left-to-right (L/R) ratio was used as an index of the relative kidney function. Mean L/R values were calculated for four follow-up time intervals. For all patients, kidney V20 (percentage of the volume of the kidney that received more than 20 Gy) and mean dose of both kidneys were retrieved from the three-dimensional dose-volume histograms. RESULTS: We observed a progressive decrease in left renal function of 11% (p = 0.012) after 6 months, up to 52% (p < 0.001) after >18 months. The V20 (left kidney) and mean left kidney dose were identified as parameters associated with decreased kidney function. Mean serum creatinine was increased from 74.6 micromol/L before treatment to 86.1 micromol/L at 1 year after chemoradiotherapy (p < 0.001). In patients with a follow-up of 18-28 months, one case of severe renovascular hypertension was observed. CONCLUSION: A progressive relative functional impairment of the left kidney in patients after postoperative chemoradiotherapy for gastric cancer is demonstrated. To optimize the survival benefit that can be established with adjuvant regimens, strategies to minimize the dose to the kidneys and other critical organs should be explored.
Affiliation:
Department of Radiotherapy, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. epm.jansen@nki.nl
Citation:
Prospective study on late renal toxicity following postoperative chemoradiotherapy in gastric cancer. 2007, 67 (3):781-5 Int. J. Radiat. Oncol. Biol. Phys.
Journal:
International Journal of Radiation Oncology, Biology, Physics
Issue Date:
1-Mar-2007
URI:
http://hdl.handle.net/10541/71039
DOI:
10.1016/j.ijrobp.2006.09.012
PubMed ID:
17157445
Type:
Article
Language:
en
ISSN:
0360-3016
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorJansen, Edwin P M-
dc.contributor.authorSaunders, Mark P-
dc.contributor.authorBoot, Henk-
dc.contributor.authorOppedijk, Vera-
dc.contributor.authorDubbelman, Ria-
dc.contributor.authorPorritt, Bridget-
dc.contributor.authorCats, Annemieke-
dc.contributor.authorStroom, Joep-
dc.contributor.authorValdés Olmos, Renato-
dc.contributor.authorBartelink, Harry-
dc.contributor.authorVerheij, Marcel-
dc.date.accessioned2009-06-19T13:41:13Z-
dc.date.available2009-06-19T13:41:13Z-
dc.date.issued2007-03-01-
dc.identifier.citationProspective study on late renal toxicity following postoperative chemoradiotherapy in gastric cancer. 2007, 67 (3):781-5 Int. J. Radiat. Oncol. Biol. Phys.en
dc.identifier.issn0360-3016-
dc.identifier.pmid17157445-
dc.identifier.doi10.1016/j.ijrobp.2006.09.012-
dc.identifier.urihttp://hdl.handle.net/10541/71039-
dc.description.abstractPURPOSE: Postoperative chemoradiotherapy in gastric cancer improves locoregional control and survival. Reports on late toxicity, however, have been scarce thus far. Because renal toxicity is one of the most serious late complications in upper abdominal radiotherapy, we prospectively analyzed kidney function in patients who underwent postoperative chemoradiotherapy for gastric cancer. PATIENTS AND METHODS: In 44 patients, Tc99m-thiatide renography was performed before and at regular intervals after postoperative chemoradiotherapy. The left-to-right (L/R) ratio was used as an index of the relative kidney function. Mean L/R values were calculated for four follow-up time intervals. For all patients, kidney V20 (percentage of the volume of the kidney that received more than 20 Gy) and mean dose of both kidneys were retrieved from the three-dimensional dose-volume histograms. RESULTS: We observed a progressive decrease in left renal function of 11% (p = 0.012) after 6 months, up to 52% (p < 0.001) after >18 months. The V20 (left kidney) and mean left kidney dose were identified as parameters associated with decreased kidney function. Mean serum creatinine was increased from 74.6 micromol/L before treatment to 86.1 micromol/L at 1 year after chemoradiotherapy (p < 0.001). In patients with a follow-up of 18-28 months, one case of severe renovascular hypertension was observed. CONCLUSION: A progressive relative functional impairment of the left kidney in patients after postoperative chemoradiotherapy for gastric cancer is demonstrated. To optimize the survival benefit that can be established with adjuvant regimens, strategies to minimize the dose to the kidneys and other critical organs should be explored.en
dc.language.isoenen
dc.subjectStomach Canceren
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAntineoplastic Agents-
dc.subject.meshBiological Markers-
dc.subject.meshChemotherapy, Adjuvant-
dc.subject.meshCisplatin-
dc.subject.meshCreatinine-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshKidney-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshProspective Studies-
dc.subject.meshRadiation Injuries-
dc.subject.meshRadiotherapy Dosage-
dc.subject.meshRadiotherapy, Adjuvant-
dc.subject.meshStomach Neoplasms-
dc.titleProspective study on late renal toxicity following postoperative chemoradiotherapy in gastric cancer.en
dc.typeArticleen
dc.contributor.departmentDepartment of Radiotherapy, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. epm.jansen@nki.nlen
dc.identifier.journalInternational Journal of Radiation Oncology, Biology, Physicsen

Related articles on PubMed

All Items in Christie are protected by copyright, with all rights reserved, unless otherwise indicated.