Utilizing the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) scale, three of the 76 patients (3.9 percent) in this study were found to have Grade 3 acute gastrointestinal (GI) toxicity, which is classified as "requiring hospitalization or elective operative intervention indicated; disabling." Only three of the remaining 73 patients experienced Grade 2 GI toxicity, which indicates a "likely duodenal obstruction creating symptomatic, altered GI function."

"Our study confirms that when the duodenal dose was kept within the prescribed limits, V55 below 15cm3, patients who received EF-IMRT had very low rates of side effects and excellent regional control," said Sushil Beriwal, MD, the study's lead author and an Associate Professor of Radiation Oncology at the University of Pittsburgh Cancer Institute, Pittsburgh, specializing in gynecologic, breast and prostate cancers. "This is one of the largest studies to examine duodenal toxicity rate for EF-IMRT treatment of gynecologic malignancies. These findings are especially important for patients who have positive metastatic disease in the para-aortic lymph nodes; they are typically the patients with advanced cervical and endometrial cancer, many of whom will likely receive concurrent chemotherapy, which can increase the risk of side effects and toxicity. EF-IMRT is an excellent option for durable control of their disease. We hope to see larger, randomized trials to further define and refine EF-IMRT for these patients."


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For a copy of the study manuscript, "Extended field intensity modulated radiation therapy for gynecologic cancers: Is the risk of duodenal toxicity high?," contact ASTRO's Press Office at press@astro.org. For more information about PRO, visit http://www.practicalradonc.org.

1 Verma J, Sulman EP, Jhingran A, et al. Dosimetric predictors of duodenal toxicity after intensity modulated radiation therapy for treatment of the para-aortic nodes in gynecologic cancer. Int J Radiat Oncol Biol Phys. 2014;88:357-362.

2 Poorvu PD, Sadow CA, Townamchai K, Damato AL, Viswanathan AN. Duodenal and other gastrointestinal toxicity in cervical and endometrial cancer treated with extended-field intensity modulated radiation therapy to paraaortic lymph nodes. Int J Radiat Oncol Biol Phys. 2013;85:1262-1268.

ABOUT ASTRO

ASTRO is the premier radiation oncology society in the world, with more than 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals that specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, the Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes two medical journals, International Journal of Radiation Oncology * Biology * Physics and Practical Radiation Oncology; developed and maintains an extensive patient website, http://www.rtanswers.org; and created the Radiation Oncology Institute, a non-profit foundation to support research and education efforts around the world that enhance and confirm the critical role of radiation therapy in improving cancer treatment. To learn more about ASTRO, visit http://www.astro.org.

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