Acute gastrointestinal toxicity after robotic stereotactic ablative radiotherapy for treatment of metastatic gynecological malignancies.
OBJECTIVE
The aim of this study was to assess acute and subacacute gastrointestinal toxicity after fractionated stereotactic ablative radiotherapy (SABR) in women having recurrent gynecological cancers in the upper abdomen.


METHODS
In total, 34 women underwent upper abdominal SABR (24 Gy/three divided 8 Gy consecutive daily doses) using a robotic Cyberknife® (Accuray, CA, USA) platform. Volumes of the duodenum receiving 10% increments of the prescription dose were associated to post-therapy gastrointestinal toxicities using binary logistic regression analyses.


RESULTS
Median clinical follow-up was 10 months. In total, 14 (41%) of the 34 women manifested grade 2 or higher post-therapy gastrointestinal adverse events. The duodenal volume, receiving 80% of a 24-Gy dose, was significantly associated with gastrointestinal toxicity (p = 0.03). However, in a multivariate analysis, only patient age at SABR adjusted the odds of experiencing gastrointestinal toxicity (p = 0.02).


CONCLUSIONS
The duodenal volume receiving 80% of 24 Gy dose may be associated with gastrointestinal toxicity from upper abdominal SABR.
Department of Radiation Oncology, University Hospitals Seidman Cancer Center & Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.
Mazen
M
Mislmani
Heidi
H
Frasure
Somu
S
Suppiah
Jeffrey
J
Fabien
Simon S
SS
Lo
Robert
R
Debernardo
Charles A
CA
Kunos
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D041981:Gastrointestinal Tract / Q000473:pathology / Q000528:radiation effects*; D005833:Genital Neoplasms, Female / Q000175:diagnosis / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D007422:Intestines / Q000473:pathology / Q000528:radiation effects; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016634:Radiosurgery / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome