title: Radiation dose-volume effects in the stomach and small bowel.
abstract: Published data suggest that the risk of moderately severe (>or=Grade 3) radiation-induced acute small-bowel toxicity can be predicted with a threshold model whereby for a given dose level, D, if the volume receiving that dose or greater (VD) exceeds a threshold quantity, the risk of toxicity escalates. Estimates of VD depend on the means of structure segmenting (e.g., V15 = 120 cc if individual bowel loops are outlined or V45 = 195 cc if entire peritoneal potential space of bowel is outlined). A similar predictive model of acute toxicity is not available for stomach. Late small-bowel/stomach toxicity is likely related to maximum dose and/or volume threshold parameters qualitatively similar to those related to acute toxicity risk. Concurrent chemotherapy has been associated with a higher risk of acute toxicity, and a history of abdominal surgery has been associated with a higher risk of late toxicity.
authors.affiliation: Department of Radiation Oncology, University of Colorado-Denver School of Medicine, Aurora, CO 80045, USA. Brian.Kavanagh@ucdenver.edu
authors.forename: Brian D
authors.initials: BD
authors.lastname: Kavanagh
authors.forename: Charlie C
authors.initials: CC
authors.lastname: Pan
authors.forename: Laura A
authors.initials: LA
authors.lastname: Dawson
authors.forename: Shiva K
authors.initials: SK
authors.lastname: Das
authors.forename: X Allen
authors.initials: XA
authors.lastname: Li
authors.forename: Randall K
authors.initials: RK
authors.lastname: Ten Haken
authors.forename: Moyed
authors.initials: M
authors.lastname: Miften
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000528:radiation effects*; D008954:Models, Biological; D011832:Radiation Injuries / Q000150:complications*; D011836:Radiation Tolerance; D011859:Radiography; D011879:Radiotherapy Dosage; D012306:Risk; D013270:Stomach / Q000000981:diagnostic imaging / Q000528:radiation effects*