Radiation Dose–Volume Effects in Radiation-Induced Rectal Injury

Published on Mar 1, 2010in International Journal of Radiation Oncology Biology Physics5.859
· DOI :10.1016/J.IJROBP.2009.03.078
Jeff M. Michalski20
Estimated H-index: 20
(WashU: Washington University in St. Louis),
Andrew Jackson59
Estimated H-index: 59
(MSK: Memorial Sloan Kettering Cancer Center)
+ 1 AuthorsJoseph O. Deasy63
Estimated H-index: 63
(WashU: Washington University in St. Louis)
The available dose/volume/outcome data for rectal injury were reviewed. The volume of rectum receiving ≥60Gy is consistently associated with the risk of Grade ≥2 rectal toxicity or rectal bleeding. Parameters for the Lyman-Kutcher-Burman normal tissue complication probability model from four clinical series are remarkably consistent, suggesting that high doses are predominant in determining the risk of toxicity. The best overall estimates (95% confidence interval) of the Lyman-Kutcher-Burman model parameters are n = 0.09 (0.04–0.14); m = 0.13 (0.10–0.17); and TD50 = 76.9 (73.7–80.1) Gy. Most of the models of late radiation toxicity come from three-dimensional conformal radiotherapy dose-escalation studies of early-stage prostate cancer. It is possible that intensity-modulated radiotherapy or proton beam dose distributions require modification of these models because of the inherent differences in low and intermediate dose distributions.
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