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J Palliat Med. 2012 Mar;15(3):370-3. doi: 10.1089/jpm.2011.0121. Epub 2012 Feb 22.

Case report: grade 4 radiation-induced colitis following conventional reirradiation to a hip metastasis.

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Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.


Palliative radiation therapy has been widely used for treatment of pain from metastatic bone disease. However, reirradiation is required in approximately 20% of patients initially treated with single fraction conventional palliative radiotherapy. There is a paucity of literature as to toxicities associated with reirradiation, and a lack of knowledge overall as to the cumulative dose limits for the organs at risk. We describe an uncommon late grade 4 adverse event of large bowel colitis in a patient initially radiated with 8 Gy in a single fraction, and reirradiated to the same area 3 months later with 20 Gy in 5 fractions due to pain progression.

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