title: Comparison of conformal and intensity modulated radiation therapy techniques for treatment of pelvic tumors. Analysis of acute toxicity.
abstract: BACKGROUND
  This retrospective analysis reports on the comparative outcome of acute gastrointestinal (GI) and genitourinary (GU) toxicities between conformal radiation therapy (CRT) and intensity modulated radiation therapy (IMRT) techniques in the treatment of patients with pelvic tumors.
  
  
  METHODS
  From January 2002 to December 2008, 69 patients with pelvic tumors underwent whole pelvic CRT and 65 underwent whole pelvic IMRT to treat pelvic lymph nodes and primary tumor regions. Total dose to the whole pelvis ranged from 50 to 50.4 Gy in 25 to 28 daily fractions. Chemotherapy (CT) regimen, when employed, was based upon primary tumor. Acute GI and GU toxicities were graded by RTOG/EORTC acute radiation morbidity criteria.
  
  
  RESULTS
  Absence of GI symptoms during radiotherapy (grade 0) was more frequently observed in the IMRT group (43.1% versus 8.7; p < 0.001) and medication for diarrhea (Grade 2) was more frequently used in the CRT group (65.2% versus 38.5%; p = 0.002). Acute GI grade 1 and 3 side effects incidence was similar in both groups (18.5% versus 18.8%; p = 0.95 and 0% versus 7.2%; p = 0.058, respectively). Incidence of GU toxicity was similar in both groups (grade 0: 61.5% versus 66.6%, p = 0.54; grade 1: 20% versus 8.7%, p = 0.06; grade 2: 18.5% versus 23.5%, p = 0.50 and grade 3: 0% versus 1.5%, p > 0.99).
  
  
  CONCLUSIONS
  This comparative case series shows less grade 2 acute GI toxicity in patients treated with whole pelvic IMRT in comparison with those treated with CRT. Incidence of acute GU toxicity was similar in both groups.
authors.affiliation: Department of Radiation Oncology, Hospital Israelita Albert Einstein, Av, Albert Einstein, 627, São Paulo-SP-05651-901-Brazil. rferrigno@einstein.br
authors.forename: Robson
authors.initials: R
authors.lastname: Ferrigno
authors.forename: Adriana
authors.initials: A
authors.lastname: Santos
authors.forename: Lidiane C
authors.initials: LC
authors.lastname: Martins
authors.forename: Eduardo
authors.initials: E
authors.lastname: Weltman
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Chen
authors.forename: Roberto
authors.initials: R
authors.lastname: Sakuraba
authors.forename: Cleverson P
authors.initials: CP
authors.lastname: Lopes
authors.forename: José C
authors.initials: JC
authors.lastname: Cruz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000453:epidemiology; D020266:Radiotherapy, Conformal / Q000009:adverse effects* / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects* / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors