Comparison of conformal and intensity modulated radiation therapy techniques for treatment of pelvic tumors. Analysis of acute toxicity

• Published in: Radiation oncology (London, England) Vol. 5; no. 1; p. 117
• Main Authors: Ferrigno, Robson, Santos, Adriana, Martins, Lidiane C, Weltman, Eduardo, Chen, Michael J, Sakuraba, Roberto, Lopes, Cleverson P, Cruz, José C
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14.12.2010; BioMed Central; BMC
• Subjects: Adult; Aged; Aged, 80 and over; Bladder; Bone marrow; Canals; Cancer; Cancer therapies; Carcinoma - epidemiology; Carcinoma - pathology; Carcinoma - radiotherapy; Chemotherapy; Drug therapy; Female; Humans; Incidence; Male; Methods; Middle Aged; Pelvic Neoplasms - epidemiology; Pelvic Neoplasms - pathology; Pelvic Neoplasms - radiotherapy; Radiation; Radiation Injuries - epidemiology; Radiation therapy; Radiotherapy; Radiotherapy, Conformal - adverse effects; Radiotherapy, Conformal - methods; Radiotherapy, Intensity-Modulated - adverse effects; Radiotherapy, Intensity-Modulated - methods; Retrospective Studies; Software; Statistical analysis; Time Factors; Tumors
• ISSN: 1748-717X; 1748-717X
• DOI: 10.1186/1748-717X-5-117

This retrospective analysis reports on the comparative outcome of acute gastrointestinal (GI) and genitourinary (GU) toxicities between conformal radiation therapy (CRT) and intensity modulated radiation therapy (IMRT) techniques in the treatment of patients with pelvic tumors. From January 2002 to December 2008, 69 patients with pelvic tumors underwent whole pelvic CRT and 65 underwent whole pelvic IMRT to treat pelvic lymph nodes and primary tumor regions. Total dose to the whole pelvis ranged from 50 to 50.4 Gy in 25 to 28 daily fractions. Chemotherapy (CT) regimen, when employed, was based upon primary tumor. Acute GI and GU toxicities were graded by RTOG/EORTC acute radiation morbidity criteria. Absence of GI symptoms during radiotherapy (grade 0) was more frequently observed in the IMRT group (43.1% versus 8.7; p < 0.001) and medication for diarrhea (Grade 2) was more frequently used in the CRT group (65.2% versus 38.5%; p = 0.002). Acute GI grade 1 and 3 side effects incidence was similar in both groups (18.5% versus 18.8%; p = 0.95 and 0% versus 7.2%; p = 0.058, respectively). Incidence of GU toxicity was similar in both groups (grade 0: 61.5% versus 66.6%, p = 0.54; grade 1: 20% versus 8.7%, p = 0.06; grade 2: 18.5% versus 23.5%, p = 0.50 and grade 3: 0% versus 1.5%, p > 0.99). This comparative case series shows less grade 2 acute GI toxicity in patients treated with whole pelvic IMRT in comparison with those treated with CRT. Incidence of acute GU toxicity was similar in both groups.