title: Predictive factors of gastroduodenal toxicity in cirrhotic patients after three-dimensional conformal radiotherapy for hepatocellular carcinoma.
abstract: 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.
authors.affiliation: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Haeyoung
authors.initials: H
authors.lastname: Kim
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Lim
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Paik
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Yoo
authors.forename: Kwang Gheol
authors.initials: KG
authors.lastname: Koh
authors.forename: Joon Hyoek
authors.initials: JH
authors.lastname: Lee
authors.forename: Moon Seok
authors.initials: MS
authors.lastname: Choi
authors.forename: Won
authors.initials: W
authors.lastname: Park
authors.forename: Hee Chul
authors.initials: HC
authors.lastname: Park
authors.forename: Seung Jae
authors.initials: SJ
authors.lastname: Huh
authors.forename: Doo Ho
authors.initials: DH
authors.lastname: Choi
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Ahn
mesh_terms: 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