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Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S123-9. doi: 10.1016/j.ijrobp.2009.03.078.

Radiation dose-volume effects in radiation-induced rectal injury.

Author information

  • 1Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA. jmichalski@radonc.wustl.edu

Abstract

The available dose/volume/outcome data for rectal injury were reviewed. The volume of rectum receiving >or=60 Gy is consistently associated with the risk of Grade >or=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 TD(50) = 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.

Copyright 2010 Elsevier Inc. All rights reserved.

PMID:
20171506
[PubMed - indexed for MEDLINE]
PMCID:
PMC3319467
Free PMC Article

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