Clinical effects in a cohort of cancer patients overexposed during external beam pelvic radiotherapy.

2.50
Hdl Handle:
http://hdl.handle.net/10541/77720
Title:
Clinical effects in a cohort of cancer patients overexposed during external beam pelvic radiotherapy.
Authors:
Borrás, Cari; Barés, Juan Pablo; Rudder, Damian; Amer, Ali M; Millán, Fernando; Abuchaibe, Oscar
Abstract:
PURPOSE: To evaluate the clinical outcome of 28 overexposed cancer patients in a cohort of 153 treated with pelvic irradiation and to correlate the outcome with the doses received. METHODS AND MATERIALS: Between August 2000 and March 2001, 153 patients were treated at the Instituto Oncológico Nacional of Panama with radiotherapy for cancers of the cervix, uterus, endometrium, prostate, and rectum using conventional techniques. In 56 patients, irradiated with partially blocked teletherapy fields, the treatment times were determined using a treatment planning system that generated isodose distributions. The absorbed doses received by the patients were calculated and the biologically effective doses (BEDs) and 2-Gy equivalent doses derived. The clinical outcome was evaluated using the Radiation Therapy Oncology Group (RTOG) and late effects on normal tissues-subjective, objective, management, analytic scales (LENT/SOMA). The relationships between clinical outcome and dose were investigated and compared with published data. RESULTS: Of the 56 patients for whom treatment times were generated with the treatment planning system, 28 received some doses per fraction approximately double those prescribed. Using an alpha/beta = 10 Gy, the tumor BED(10) values ranged from 77 to 225 Gy. The rest of the patients received doses within 10% of the prescribed values. Seventeen of the 28 overexposed patients died 35 days to 21 months after treatment; 13 of the fatalities were caused by rectal complications. Survival was longer in those patients who had undergone colostomy. Bladder complications were less enhanced. The nonoverexposed patients with cervical cancer exhibited a greater incidence of treatment failures than generally reported in other centers. CONCLUSION: This study provides the clinical outcome after high doses of pelvic radiotherapy in a range not previously well documented. For cervical cancer patients receiving both tele- and brachytherapy, some deaths in this overexposure cohort occurred from assumed consequential rectal injury within 2 years, when the BED(10) values exceeded 70-80 Gy. The incidence was asymptotic to 100% fatalities at >150 Gy. This confirmed and extended other data in the literature.
Affiliation:
Pan American Health Organization, Washington, DC, USA. cariborvas@verizon.net
Citation:
Clinical effects in a cohort of cancer patients overexposed during external beam pelvic radiotherapy. 2004, 59 (2):538-50 Int. J. Radiat. Oncol. Biol. Phys.
Journal:
International Journal of Radiation Oncology, Biology, Physics
Issue Date:
1-Jun-2004
URI:
http://hdl.handle.net/10541/77720
DOI:
10.1016/j.ijrobp.2003.10.024
PubMed ID:
15145174
Type:
Article
Language:
en
ISSN:
0360-3016
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorBorrás, Cari-
dc.contributor.authorBarés, Juan Pablo-
dc.contributor.authorRudder, Damian-
dc.contributor.authorAmer, Ali M-
dc.contributor.authorMillán, Fernando-
dc.contributor.authorAbuchaibe, Oscar-
dc.date.accessioned2009-08-18T15:34:26Z-
dc.date.available2009-08-18T15:34:26Z-
dc.date.issued2004-06-01-
dc.identifier.citationClinical effects in a cohort of cancer patients overexposed during external beam pelvic radiotherapy. 2004, 59 (2):538-50 Int. J. Radiat. Oncol. Biol. Phys.en
dc.identifier.issn0360-3016-
dc.identifier.pmid15145174-
dc.identifier.doi10.1016/j.ijrobp.2003.10.024-
dc.identifier.urihttp://hdl.handle.net/10541/77720-
dc.description.abstractPURPOSE: To evaluate the clinical outcome of 28 overexposed cancer patients in a cohort of 153 treated with pelvic irradiation and to correlate the outcome with the doses received. METHODS AND MATERIALS: Between August 2000 and March 2001, 153 patients were treated at the Instituto Oncológico Nacional of Panama with radiotherapy for cancers of the cervix, uterus, endometrium, prostate, and rectum using conventional techniques. In 56 patients, irradiated with partially blocked teletherapy fields, the treatment times were determined using a treatment planning system that generated isodose distributions. The absorbed doses received by the patients were calculated and the biologically effective doses (BEDs) and 2-Gy equivalent doses derived. The clinical outcome was evaluated using the Radiation Therapy Oncology Group (RTOG) and late effects on normal tissues-subjective, objective, management, analytic scales (LENT/SOMA). The relationships between clinical outcome and dose were investigated and compared with published data. RESULTS: Of the 56 patients for whom treatment times were generated with the treatment planning system, 28 received some doses per fraction approximately double those prescribed. Using an alpha/beta = 10 Gy, the tumor BED(10) values ranged from 77 to 225 Gy. The rest of the patients received doses within 10% of the prescribed values. Seventeen of the 28 overexposed patients died 35 days to 21 months after treatment; 13 of the fatalities were caused by rectal complications. Survival was longer in those patients who had undergone colostomy. Bladder complications were less enhanced. The nonoverexposed patients with cervical cancer exhibited a greater incidence of treatment failures than generally reported in other centers. CONCLUSION: This study provides the clinical outcome after high doses of pelvic radiotherapy in a range not previously well documented. For cervical cancer patients receiving both tele- and brachytherapy, some deaths in this overexposure cohort occurred from assumed consequential rectal injury within 2 years, when the BED(10) values exceeded 70-80 Gy. The incidence was asymptotic to 100% fatalities at >150 Gy. This confirmed and extended other data in the literature.en
dc.language.isoenen
dc.subjectUterine Cervical Canceren
dc.subjectUterine Canceren
dc.subjectProstatic Canceren
dc.subjectRectal Canceren
dc.subjectEndometrial Canceren
dc.subject.meshEndometrial Neoplasms-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshProstatic Neoplasms-
dc.subject.meshRadiation Injuries-
dc.subject.meshRadiotherapy Dosage-
dc.subject.meshRectal Neoplasms-
dc.subject.meshRectum-
dc.subject.meshTreatment Outcome-
dc.subject.meshUrinary Bladder-
dc.subject.meshUterine Cervical Neoplasms-
dc.subject.meshUterine Neoplasms-
dc.titleClinical effects in a cohort of cancer patients overexposed during external beam pelvic radiotherapy.en
dc.typeArticleen
dc.contributor.departmentPan American Health Organization, Washington, DC, USA. cariborvas@verizon.neten
dc.identifier.journalInternational Journal of Radiation Oncology, Biology, Physicsen

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