Zheng Min,He Ling,Xu Jinghui,Ma Jiabao,Fan Yu,Xie Fei,Liu Guangrong,Fan Lingli,Wang Jie.An analysis of dose-volume-time relationship for acute radiation proctitis in cervical cancer patients[J].Chinese Journal of Radiological Medicine and Protection,2017,37(3):205-209
An analysis of dose-volume-time relationship for acute radiation proctitis in cervical cancer patients
Received:September 19, 2016  
DOI:10.3760/cma.j.issn.0254-5098.2017.03.008
KeyWords:Cervical cancer  Intensity-modulated radiation therapy  External beam radiotherapy  Acute radiation proctitis
FundProject:国家临床重点专科建设项目资助,福建省临床重点专科建设项目资助,福建省医学创新课题(2014-CXB-5)
Author NameAffiliationE-mail
Zheng Min Sichuan Cancer Hospital, Chengdu 610041, China  
He Ling Sichuan Province Center for Disease Control and Prevention, Chengdu 610041, China  
Xu Jinghui Sichuan Cancer Hospital, Chengdu 610041, China  
Ma Jiabao Sichuan Cancer Hospital, Chengdu 610041, China  
Fan Yu Sichuan Cancer Hospital, Chengdu 610041, China  
Xie Fei Deyang People's Hospital of Sichuan Province, Deyang 618000, China  
Liu Guangrong Sichuan Cancer Hospital, Chengdu 610041, China  
Fan Lingli Mianyang Central Hospital of Sichuan Province, Mianyang 612000, China  
Wang Jie Sichuan Cancer Hospital, Chengdu 610041, China wxr792000@163.com 
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Abstract::
      Objective To investigate the relationship between acute radiation proctitis and radiation dose, volume as well as radiation time, in the process of intensity-modulated radiation therapy (IMRT) for the cervical cancer patients. Methods A total of 51 patients with locally advanced cervical cancer were enrolled from January 2011 to December 2013. Those patients were then classified into grade 1 to 4 groups, according to the RTOG/EORTC toxicity grading standard. The exposure dose volume and the average dose of rectum under the standard plan were evaluated with dose-volume histogram (DVH). The ANOVA test was used for analyzing Dmax, Dmean, D1 cm3, D2 cm3, D40 and V40 values of rectum and the average exposure dose of rectum. Results The average time of acute radiation proctitis with clinical symptoms was (23.06±12.01) d after radiotherapy. Dmax values of rectum in grade 2 group was lower than those in grade 3 and 4 groups (F=5.268, P<0.05). Moreover, D1 cm3 and D2 cm3 values of rectum in grade 1 and 2 groups were also lower than those in grade 3 and 4 groups (F=4.893, 4.406,P<0.05). There was no statistically significant difference between D40 and V40 values. Conclusions The acute radiation proctitis could be frequently found around 20 days during the IMRT for cervical cancer patients. Mild and moderate acute radiation proctitis are more common, while severe acute radiation proctitis is rare. Minimizing Dmax, D1 cm3 and D2 cm3 values of rectum might reduce the incidence of severe acute radiation proctitis in cervical cancer patients receiving IMRT.
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