Early intestinal changes following abdominal radiotherapy comparison of endpoints.
OBJECTIVE
To compare tests for intestinal function with clinical scores after abdominal irradiation.


METHODS
At the Department of Radiotherapy, Erfurt, Germany, intestinal changes were studied in 91 patients receiving abdominal radiotherapy between 1992 and 1996. Conventional fractionation (1.8-2 Gy per fraction, total doses 30.6-62.5 Gy) was applied. Before and at weekly intervals during radiotherapy, the clinical response was scored according to RTOG/EORTC for the upper and lower gastrointestinal (GI) tract. Resorption tests for vitamin B(12) and D-xylose were performed before the onset and immediately after treatment.


RESULTS
The clinical response displayed a well-defined dose-effect relationship with grade 1 effects in 5% and 50% of the patients at about 10 Gy and 50 Gy, respectively. For grade 2 reactions, 5%- and 50%-effective doses were 20-30 Gy and 60-80 Gy. Effects in the upper and lower GI tract were highly correlated. Changes in body weight did not show a correlation with other clinical symptoms. Changes in resorption also displayed a significant dose effect. However, no correlation was found with the clinical symptoms in the individual patient.


CONCLUSIONS
In the present study, the clinical manifestation of intestinal side effects according to RTOG/EORTC criteria was reflected by neither the vitamin B(12) nor by the D-xylose resorption test. Hence, these tests cannot be regarded as useful for objective quantitation of intestinal radiation injury.
Dörr
Wolfgang
W
Department of Radiotherapy and Radiooncology, Medical Faculty Carl Gustav Carus, Technical University, Dresden, Germany. doerr@rcs.urz.tu-dresden.de
Köst
Sabine
S
Keinert
Klaus
K
Glaser
Felix-Herbert
FH
Endert
Gerd
G
Herrmann
Thomas
T
D000005:Abdomen / Q000528:radiation effects; D000293:Adolescent; D000328:Adult; D000368:Aged; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006689:Hodgkin Disease / Q000532:radiotherapy; D006801:Humans; D007408:Intestinal Absorption / Q000528:radiation effects; D007422:Intestines / Q000528:radiation effects*; D007680:Kidney Neoplasms / Q000532:radiotherapy; D008228:Lymphoma, Non-Hodgkin / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011832:Radiation Injuries / Q000175:diagnosis*; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012208:Rhabdomyosarcoma / Q000532:radiotherapy; D018239:Seminoma / Q000532:radiotherapy; D013274:Stomach Neoplasms / Q000532:radiotherapy; D013736:Testicular Neoplasms / Q000532:radiotherapy; D013997:Time Factors; D014805:Vitamin B 12 / Q000493:pharmacokinetics; D014994:Xylose / Q000493:pharmacokinetics
D014994:Xylose; D014805:Vitamin B 12