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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.

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  • 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.

PMID:
20171506
PMCID:
PMC3319467
DOI:
10.1016/j.ijrobp.2009.03.078
[PubMed - indexed for MEDLINE]
Free PMC Article
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