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[Normal tissue tolerance to external beam radiation therapy: rectum].

P Blanchard1, O Chapet

  • 1Département de Radiothérapie, Institut Gustave-Roussy, 114 Rue Edouard Vaillant, 94805 Villejuif, France. pierre.blanchard@igr.fr

Cancer Radiotherapie : Journal De La Societe Francaise De Radiotherapie Oncologique
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Summary

Radiation proctitis, a common side effect of radiotherapy for pelvic tumors, often presents with rectal bleeding within two years post-treatment. Clinical and dosimetric factors can predict its occurrence, aiding in treatment adaptation.

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Gastroenterology

Background:

  • Radiation proctitis is a frequent toxicity following radiotherapy for pelvic malignancies.
  • Late rectal toxicity typically manifests within two years after radiation therapy completion.
  • Key symptoms include rectal bleeding and rectal syndrome, potentially involving fistulas or ulcers.

Purpose of the Study:

  • To identify clinical and dosimetric factors associated with late rectal toxicity after pelvic radiotherapy.
  • To provide insights for predicting and potentially mitigating radiation proctitis.
  • To inform adjustments in radiation dose and delivery techniques.

Main Methods:

  • Review of clinical data and patient factors (e.g., diabetes, acute toxicity, rectal volume, hypersensitivity).
  • Analysis of dosimetric factors using dose-volume histograms.
  • Correlation of identified factors with the occurrence of late rectal toxicity.

Main Results:

  • Several clinical factors, including diabetes mellitus, severe acute radiation toxicity, small rectal volume, and radiation hypersensitivity, are linked to late rectal toxicity.
  • Dosimetric factors derived from dose-volume histograms can predict radiation proctitis development.
  • These findings highlight predictive markers for radiation-induced rectal injury.

Conclusions:

  • Late rectal toxicity is a significant concern in pelvic radiotherapy.
  • Predictive clinical and dosimetric factors can help identify at-risk patients.
  • Adapting radiation dose and treatment planning based on these factors may reduce the incidence of radiation proctitis.