Klinische Sicherheit und Wirksamkeit der Salvage-Rebestrahlung bei bösartigen Tumoren im oberen Abdominalbereich

Translated title of the contribution: Clinical safety and efficacy of salvage reirradiation for upper abdominal malignancies

Jason Joon Bock Lee, Seo Hee Choi, Jung Ho Im, Jinsil Seong

Research output: Contribution to journalArticle

Abstract

Purpose: Reirradiation has the potential to provide effective local control of upper abdominal malignancies. This study aimed to evaluate the safety and efficacy of reirradiation for upper abdominal malignancies. Methods: A total of 42 patients with a history of prior radiotherapy (RT) received reirradiation for abdominal malignancies between 2005 and 2017. Each patient’s medical records, contours, and dose distribution for both RT courses were reviewed. The median dose of the prior RT was 50.0 Gy (range, 30.0–60.0 Gy) and the median dose of reirradiation was 45.0 Gy (range, 15.0–75.0 Gy). Results: With a median follow-up of 10.9 months, the median infield-failure-free survival (IFFS) rate was 9.2 months. Gross tumor volume (GTV) significantly related to IFFS in both the univariate (p = 0.009) and multivariate analyses (p = 0.024), and patients with a GTV of <60.0 mL had an improved IFFS (p = 0.001). Four patients experienced ≥grade 3 late toxicities. In the retrospective dose reconstruction analysis in these patients, the cumulative dose to the most exposed 2 cc (D2cc) of the duodenum was >60.0 Gy (range, 60.1–73.7 Gy). In the univariate analysis, the D2cc of the duodenum and a preexisting duodenal ulcer identified using endoscopy prior to reirradiation significantly correlated with late severe toxicity (p = 0.021 and 0.017, respectively). Conclusions: Reirradiation for upper abdominal malignancies could be safely performed for patients without preexisting gastrointestinal morbidity unless the duodenum received excessive radiation doses. Reirradiation could also provide substantial IFFS, especially for patients with a GTV of <60.0 mL.

Original languageGerman
Pages (from-to)526-533
Number of pages8
JournalStrahlentherapie und Onkologie
Volume195
Issue number6
DOIs
Publication statusPublished - 2019 Jun 1

Fingerprint

Safety
Neoplasms
Radiotherapy
Duodenum
Survival
Duodenal Ulcer
Re-Irradiation
Tumor Burden
Endoscopy
Medical Records
Multivariate Analysis
Survival Rate
Radiation
Morbidity

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Oncology

Cite this

@article{a3423e3786424af789f40f4c16d1292d,
title = "Klinische Sicherheit und Wirksamkeit der Salvage-Rebestrahlung bei b{\"o}sartigen Tumoren im oberen Abdominalbereich",
abstract = "Purpose: Reirradiation has the potential to provide effective local control of upper abdominal malignancies. This study aimed to evaluate the safety and efficacy of reirradiation for upper abdominal malignancies. Methods: A total of 42 patients with a history of prior radiotherapy (RT) received reirradiation for abdominal malignancies between 2005 and 2017. Each patient’s medical records, contours, and dose distribution for both RT courses were reviewed. The median dose of the prior RT was 50.0 Gy (range, 30.0–60.0 Gy) and the median dose of reirradiation was 45.0 Gy (range, 15.0–75.0 Gy). Results: With a median follow-up of 10.9 months, the median infield-failure-free survival (IFFS) rate was 9.2 months. Gross tumor volume (GTV) significantly related to IFFS in both the univariate (p = 0.009) and multivariate analyses (p = 0.024), and patients with a GTV of <60.0 mL had an improved IFFS (p = 0.001). Four patients experienced ≥grade 3 late toxicities. In the retrospective dose reconstruction analysis in these patients, the cumulative dose to the most exposed 2 cc (D2cc) of the duodenum was >60.0 Gy (range, 60.1–73.7 Gy). In the univariate analysis, the D2cc of the duodenum and a preexisting duodenal ulcer identified using endoscopy prior to reirradiation significantly correlated with late severe toxicity (p = 0.021 and 0.017, respectively). Conclusions: Reirradiation for upper abdominal malignancies could be safely performed for patients without preexisting gastrointestinal morbidity unless the duodenum received excessive radiation doses. Reirradiation could also provide substantial IFFS, especially for patients with a GTV of <60.0 mL.",
author = "Lee, {Jason Joon Bock} and Choi, {Seo Hee} and Im, {Jung Ho} and Jinsil Seong",
year = "2019",
month = "6",
day = "1",
doi = "10.1007/s00066-018-01420-7",
language = "German",
volume = "195",
pages = "526--533",
journal = "Strahlentherapie und Onkologie",
issn = "0179-7158",
publisher = "Urban und Vogel",
number = "6",

}

Klinische Sicherheit und Wirksamkeit der Salvage-Rebestrahlung bei bösartigen Tumoren im oberen Abdominalbereich. / Lee, Jason Joon Bock; Choi, Seo Hee; Im, Jung Ho; Seong, Jinsil.

In: Strahlentherapie und Onkologie, Vol. 195, No. 6, 01.06.2019, p. 526-533.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Klinische Sicherheit und Wirksamkeit der Salvage-Rebestrahlung bei bösartigen Tumoren im oberen Abdominalbereich

AU - Lee, Jason Joon Bock

AU - Choi, Seo Hee

AU - Im, Jung Ho

AU - Seong, Jinsil

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Purpose: Reirradiation has the potential to provide effective local control of upper abdominal malignancies. This study aimed to evaluate the safety and efficacy of reirradiation for upper abdominal malignancies. Methods: A total of 42 patients with a history of prior radiotherapy (RT) received reirradiation for abdominal malignancies between 2005 and 2017. Each patient’s medical records, contours, and dose distribution for both RT courses were reviewed. The median dose of the prior RT was 50.0 Gy (range, 30.0–60.0 Gy) and the median dose of reirradiation was 45.0 Gy (range, 15.0–75.0 Gy). Results: With a median follow-up of 10.9 months, the median infield-failure-free survival (IFFS) rate was 9.2 months. Gross tumor volume (GTV) significantly related to IFFS in both the univariate (p = 0.009) and multivariate analyses (p = 0.024), and patients with a GTV of <60.0 mL had an improved IFFS (p = 0.001). Four patients experienced ≥grade 3 late toxicities. In the retrospective dose reconstruction analysis in these patients, the cumulative dose to the most exposed 2 cc (D2cc) of the duodenum was >60.0 Gy (range, 60.1–73.7 Gy). In the univariate analysis, the D2cc of the duodenum and a preexisting duodenal ulcer identified using endoscopy prior to reirradiation significantly correlated with late severe toxicity (p = 0.021 and 0.017, respectively). Conclusions: Reirradiation for upper abdominal malignancies could be safely performed for patients without preexisting gastrointestinal morbidity unless the duodenum received excessive radiation doses. Reirradiation could also provide substantial IFFS, especially for patients with a GTV of <60.0 mL.

AB - Purpose: Reirradiation has the potential to provide effective local control of upper abdominal malignancies. This study aimed to evaluate the safety and efficacy of reirradiation for upper abdominal malignancies. Methods: A total of 42 patients with a history of prior radiotherapy (RT) received reirradiation for abdominal malignancies between 2005 and 2017. Each patient’s medical records, contours, and dose distribution for both RT courses were reviewed. The median dose of the prior RT was 50.0 Gy (range, 30.0–60.0 Gy) and the median dose of reirradiation was 45.0 Gy (range, 15.0–75.0 Gy). Results: With a median follow-up of 10.9 months, the median infield-failure-free survival (IFFS) rate was 9.2 months. Gross tumor volume (GTV) significantly related to IFFS in both the univariate (p = 0.009) and multivariate analyses (p = 0.024), and patients with a GTV of <60.0 mL had an improved IFFS (p = 0.001). Four patients experienced ≥grade 3 late toxicities. In the retrospective dose reconstruction analysis in these patients, the cumulative dose to the most exposed 2 cc (D2cc) of the duodenum was >60.0 Gy (range, 60.1–73.7 Gy). In the univariate analysis, the D2cc of the duodenum and a preexisting duodenal ulcer identified using endoscopy prior to reirradiation significantly correlated with late severe toxicity (p = 0.021 and 0.017, respectively). Conclusions: Reirradiation for upper abdominal malignancies could be safely performed for patients without preexisting gastrointestinal morbidity unless the duodenum received excessive radiation doses. Reirradiation could also provide substantial IFFS, especially for patients with a GTV of <60.0 mL.

UR - http://www.scopus.com/inward/record.url?scp=85060703842&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060703842&partnerID=8YFLogxK

U2 - 10.1007/s00066-018-01420-7

DO - 10.1007/s00066-018-01420-7

M3 - Article

C2 - 30689025

AN - SCOPUS:85060703842

VL - 195

SP - 526

EP - 533

JO - Strahlentherapie und Onkologie

JF - Strahlentherapie und Onkologie

SN - 0179-7158

IS - 6

ER -