PMID- 17609872
OWN - NLM
STAT- MEDLINE
DCOM- 20080107
LR  - 20070704
IS  - 1439-099X (Electronic)
IS  - 0179-7158 (Linking)
VI  - 183
IP  - 7
DP  - 2007 Jul
TI  - Optimized conformal paraaortic lymph node irradiation is not associated with 
      enhanced renal toxicity.
PG  - 385-91
AB  - BACKGROUND AND PURPOSE: For patients with gynecologic carcinomas, irradiation of 
      paraaortic lymph nodes (PLNs) is a routine treatment concept. Planning target 
      volumes (PTVs) individually optimized by radiation field delineations along the 
      big vessels permit the inclusion of at least 97% of potentially involved PLNs. 
      However, this novel treatment technique might increase radiation-induced 
      nephrotoxicity. Therefore, the actual incidence of kidney damage after PLN 
      irradiation has to be assessed in order to validate the safety of this treatment 
      concept. PATIENTS AND METHODS: 19 patients were treated with irradiation alone 
      (50.4 Gy; 5 x 1.8 Gy/week) and monitored for up to 90 months. Functional renal 
      parameters, namely renal plasma flow (RPF) and glomerular filtration rate (GFR), 
      were assessed by dynamic renal scintigraphy. Additionally, patients were 
      clinically observed (i.e., hypertension, proteinuria) and calculations of 
      normal-tissue complication probability (NTCP) values for nonuniform kidney 
      irradiation were performed using the Lyman-Wolbarst algorithm. RESULTS: Two 
      patients with anticipated moderate NTCP values (12.6% and 8.7%) showed slightly 
      impaired RPF rates at 12, 24, and after 48 months of follow-up. Only one patient 
      in the subgroup showing NTCP values > 50% (n = 9) developed a notable impairment 
      of renal RPF. However, all patients including those with elevated complication 
      probabilities exhibited neither impaired GFR nor clinically apparent symptoms 
      related to a loss of functioning renal tissue from 12 to > 48 months post 
      irradiation. CONCLUSION: Conformal irradiation of retroperitoneal lymph nodes 
      with individual PTV delineation appears not to be associated with clinically 
      relevant functional impairment of the kidneys.
FAU - Nevinny-Stickel, Meinhard
AU  - Nevinny-Stickel M
AD  - Department of Therapeutic Radiology and Oncology, Innsbruck Medical University, 
      Austria. meinhard.nevinny@uibk.ac.at
FAU - Poljanc, Karin
AU  - Poljanc K
FAU - Forthuber, Britta C
AU  - Forthuber BC
FAU - Heute, Dirk
AU  - Heute D
FAU - Posch, Andrea
AU  - Posch A
FAU - Lechner, Judith
AU  - Lechner J
FAU - Beer, Beate
AU  - Beer B
FAU - Lukas, Peter
AU  - Lukas P
FAU - Seppi, Thomas
AU  - Seppi T
LA  - eng
PT  - Controlled Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Strahlenther Onkol
JT  - Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et 
      al]
JID - 8603469
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aorta/radiation effects
MH  - Carcinoma/*radiotherapy/*secondary
MH  - Female
MH  - Genital Neoplasms, Female/*radiotherapy
MH  - Humans
MH  - Kidney Diseases/*diagnosis/*etiology
MH  - Lymph Nodes/*radiation effects
MH  - Lymphatic Metastasis
MH  - Middle Aged
MH  - Radiation Injuries/*diagnosis/*etiology
MH  - Radiotherapy, Conformal/*methods
MH  - Treatment Outcome
EDAT- 2007/07/05 09:00
MHDA- 2008/01/08 09:00
CRDT- 2007/07/05 09:00
PHST- 2006/08/01 00:00 [received]
PHST- 2007/04/03 00:00 [accepted]
PHST- 2007/07/05 09:00 [pubmed]
PHST- 2008/01/08 09:00 [medline]
PHST- 2007/07/05 09:00 [entrez]
AID - 10.1007/s00066-007-1657-6 [doi]
PST - ppublish
SO  - Strahlenther Onkol. 2007 Jul;183(7):385-91. doi: 10.1007/s00066-007-1657-6.