Radiation dose-volume effects in the stomach and small bowel.
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.
Kavanagh
Brian D
BD
Department of Radiation Oncology, University of Colorado-Denver School of Medicine, Aurora, CO 80045, USA. Brian.Kavanagh@ucdenver.edu
Pan
Charlie C
CC
Dawson
Laura A
LA
Das
Shiva K
SK
Li
X Allen
XA
Ten Haken
Randall K
RK
Miften
Moyed
M
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*