Context: Definitive concurrent chemoradiation with brachytherapy is the prime modality of treatment of cervical cancer. The small bowel is one of the critical organs responsible for gastrointestinal complications.
Aims: This study aims to analyze the relation of small bowel dosimetric parameters with the incidence of acute gastrointestinal complications.
Subjects And Methods: The study analyzed 40 patients of stage IIB-IVA who underwent concurrent chemoradiation with three-dimensional conformal radiotherapy and weekly cisplatin from June 2017 to June 2018. The small bowel was contoured as the organ of risk. Dose-volume histogram parameters of the small bowel subjected to analysis were mean dose, maximum dose, the total volume of organ receiving 20 Gy, 40 Gy, and 45 Gy (V20-45), and the volume of V20-45 to total volume (V20-45 ratio). Gastrointestinal toxicity was graded using CTCAE version 5.0 criteria. Association between dosimetric parameters and incidence of 1-2 gastrointestinal complications were evaluated.
Results: A total of forty patients treated with concurrent chemoradiation were analyzed. Seven patients reported Grade 1, whereas three patients reported Grade 2 gastrointestinal complications. None of the patients reported Grade 3 or higher gastrointestinal complication. Patients with gastrointestinal complications had greater V30-45 and mean dose as compared to those without gastrointestinal complication.
Conclusions: Dosimetric parameters of small bowel should be evaluated to reduce the incidence of gastrointestinal complications.
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| http://dx.doi.org/10.4103/jcrt.JCRT_313_19 | DOI Listing |
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