PMID- 18705399
OWN - NLM
STAT- MEDLINE
DCOM- 20080828
LR  - 20221007
IS  - 0300-8916 (Print)
IS  - 0300-8916 (Linking)
VI  - 94
IP  - 3
DP  - 2008 May-Jun
TI  - Are doses to ICRU reference points valuable for predicting late rectal and 
      bladder morbidity after definitive radiotherapy in uterine cervix cancer?
PG  - 327-32
AB  - AIMS AND BACKGROUND: To evaluate whether doses or dose rates at International 
      Commission on Radiation Units (ICRU) reference points are of value for predicting 
      risks of late rectal and bladder morbidity in patients with uterine cervical 
      cancer who have undergone external beam radiotherapy and intracavitary 
      irradiation. METHODS: Late rectal complications and late bladder complications 
      were evaluated in 54 patients who were treated by external beam radiotherapy 
      followed by intracavitary irradiation between January 1996 and December 1999. 
      External beam radiotherapy was delivered in 1.8 Gy daily fractions to a whole 
      pelvis dose of 50.4 Gy followed by intracavitary irradiation at total point A 
      doses ranging from 75 Gy to 85 Gy. Intracavitary irradiation was performed with 
      dose rates of 0.5-0.7 Gy/h to point A in most patients, but 8 patients were 
      treated at a higher dose rate (0.83-1.15 Gy/h) to shorten the hospitalization 
      period. Biologically effective doses for the reference points were calculated 
      using a linear quadratic model. RESULTS: Grade 3 rectal and bladder morbidity by 
      Radiation Therapy Oncology Group (RTOG) criteria developed in 4 patients (7.4%) 
      and 1 (1.9%), respectively. An age of >60 years (P = 0.01) and a total dose to 
      the rectal reference point of > or =80 Gy (P = 0.03) were found to be correlated 
      with a higher rate of rectal morbidity. Total dose (> or =80 Gy), dose rate (> or 
      = 0.75 Gy/h), and biologically effective doses (> or =135 Gy3) at the bladder 
      reference point were found to be significant factors for the development of late 
      bladder morbidity. By multivariate analysis, age was identified as the only 
      significant factor of late rectal complications, and biologically effective doses 
      at the bladder reference point was the only significant factor of late bladder 
      complications. CONCLUSIONS: RTOG grade 3 late rectal and bladder morbidity 
      developed in respectively 7.4% and 1.9% of the patients. The significant risk 
      factors for late rectal and bladder morbidity were old age and biologically 
      effective doses at the bladder reference point, respectively.
FAU - Kim, Hak Jae
AU  - Kim HJ
AD  - Department of Radiation Oncology, Seoul National University College of Medicine, 
      South Korea.
FAU - Kim, Suzy
AU  - Kim S
FAU - Ha, Sung Whan
AU  - Ha SW
FAU - Wu, Hong-Gyun
AU  - Wu HG
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Tumori
JT  - Tumori
JID - 0111356
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Analysis of Variance
MH  - Brachytherapy/adverse effects
MH  - Chemotherapy, Adjuvant
MH  - Dose Fractionation, Radiation
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Predictive Value of Tests
MH  - Radiation Injuries/*etiology/pathology
MH  - Radiotherapy Dosage
MH  - Radiotherapy, Adjuvant
MH  - Rectum/*radiation effects
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Urinary Bladder/*radiation effects
MH  - Uterine Cervical Neoplasms/pathology/*radiotherapy
EDAT- 2008/08/19 09:00
MHDA- 2008/08/30 09:00
CRDT- 2008/08/19 09:00
PHST- 2008/08/19 09:00 [pubmed]
PHST- 2008/08/30 09:00 [medline]
PHST- 2008/08/19 09:00 [entrez]
AID - 10.1177/030089160809400307 [doi]
PST - ppublish
SO  - Tumori. 2008 May-Jun;94(3):327-32. doi: 10.1177/030089160809400307.