Predictive factors of gastroduodenal toxicity in cirrhotic patients after three-dimensional conformal radiotherapy for hepatocellular carcinoma.
OBJECTIVE
To identify predictive factors for the development of gastroduodenal toxicity (GDT) in cirrhotic patients treated with three-dimensional conformal radiotherapy (3D-CRT) for hepatocellular carcinoma (HCC).


METHODS
We retrospectively analyzed dose-volume histograms (DVHs) and clinical records of 73 cirrhotic patients treated with 3D-CRT for HCC. The median radiation dose was 36 Gy (range, 30-54 Gy) with a daily dose of 3 Gy. The grade of GDT was defined by the Common Toxicity Criteria Version 2. The predictive factors of grade 3 GDT were identified.


RESULTS
Grade 3 GDT was found in 9 patients. Patient's age and the percentage of gastroduodenal volume receiving more than 35 Gy (V(35)) significantly affected the development of grade 3 GDT. Patients over 50 years of age developed grade 3 GDT more frequently than patients under 50 years of age. The risk of grade 3 GDT grew exponentially as V(35) increased. The 1-year actuarial rate of grade 3 GDT in patients with V(35)<5% is significantly lower than that in patients with a V(35)> or =5% (4% vs. 48%, p<.01).


CONCLUSIONS
Patient's age and V(35) were the most predictive factors for the development of grade 3 GDT in patients treated with RT.
Kim
Haeyoung
H
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Lim
Do Hoon
DH
Paik
Seung Woon
SW
Yoo
Byung Chul
BC
Koh
Kwang Gheol
KG
Lee
Joon Hyoek
JH
Choi
Moon Seok
MS
Park
Won
W
Park
Hee Chul
HC
Huh
Seung Jae
SJ
Choi
Doo Ho
DH
Ahn
Yong Chan
YC
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy*; D004386:Duodenum / Q000187:drug effects*; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D012189:Retrospective Studies