Improved Understanding of Subtle Rectal Toxicity After Prostate Brachytherapy: Results with a Comprehensive Toxicity Scoring System and Identification of Rectal Dosimetric Toxicity Predictors

2005 ◽  
Vol 63 ◽  
pp. S316-S317
Author(s):  
J.N. Shah ◽  
R.D. Ennis
Keyword(s):  
Scoring System ◽  
Prostate Brachytherapy ◽  
Rectal Toxicity ◽  
Toxicity Scoring

scholarly journals Development of an Objective Scoring System for Endoscopic Assessment of Radiation-Induced Upper Gastrointestinal Toxicity

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2136
Author(s):  
Daniel Lin ◽  
Shalini Moningi ◽  
Joseph Abi Jaoude ◽  
Ben S. Singh ◽  
Irina M. Cazacu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Radiation Therapy ◽  
Scoring System ◽  
Interobserver Agreement ◽  
Locally Advanced ◽  
Severe Toxicity ◽  
Cancer Trial ◽  
Gi Toxicity ◽  
Upper Gastrointestinal ◽  
Toxicity Scoring

We developed and implemented an objective toxicity scoring system to be used during endoscopic evaluation of the upper gastrointestinal (GI) tract in order to directly assess changes in toxicity during the radiation treatment of pancreatic cancer. We assessed and validated the upper GI toxicity of 19 locally advanced pancreatic cancer trial patients undergoing stereotactic body radiation therapy (SBRT). Wilcoxon-signed rank tests were used to compare pre- and post-SBRT scores. Comparison of the toxicity scores measured before and after SBRT revealed a mild increase in toxicity in the stomach and duodenum (p < 0.005), with no cases of severe toxicity observed. Kappa and AC1 statistics analysis were used to evaluate interobserver agreement. Our toxicity scoring system was reliable in determining GI toxicity with a good overall interobserver agreement for pre-treatment scores (stomach, κ = 0.71, p < 0.005; duodenum, κ = 0.88, p < 0.005) and post-treatment scores (stomach, κ = 0.71, p < 0.005; duodenum, κ = 0.76, p < 0.005). The AC1 statistics yielded similar results. With future usage, we hope this scoring system will be a useful tool for objectively and reliably assessing changes in GI toxicity during the treatment of pancreatic cancer and for GI toxicity assessments and comparisons during radiation therapy research trials.

Predicting the risk of gastrointestinal (GI) toxicity in early colon cancer (CC) patients (pts) treated with adjuvant chemotherapy: Developing a GI toxicity scoring system.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 420-420
Author(s):  
Gillian Gresham ◽  
Jasleen Sidhu ◽  
Navraj Malhi ◽  
Winson Y. Cheung
Keyword(s):  
Adjuvant Chemotherapy ◽  
Scoring System ◽  
Risk Groups ◽  
Multivariate Model ◽  
Parameter Estimates ◽  
Study Cohort ◽  
Clinical Factors ◽  
Gi Toxicity ◽  
Folfox Chemotherapy ◽  
Toxicity Scoring

420 Background: Baseline demographics and clinical factors may contribute to a pt’s overall risk for developing chemotherapy-related GI toxicity, such as nausea, vomiting, and diarrhea. We aimed to develop a GI toxicity scoring system to better stratify early CC pts who may be at higher risk of developing GI toxicity from adjuvant FOLFOX chemotherapy. Methods: Pts diagnosed with early CC from 2005 to 2008 and treated with FOLFOX at the British Columbia Cancer Agency were reviewed. GI toxicities of interest included (1) nausea/vomiting, (2) diarrhea, and (3) any GI side effects. Baseline variables that were analyzed consisted of age, sex, ECOG, time to adjuvant chemotherapy (TTAC), and laboratory parameters. Stepwise regression was used to develop a multivariate model for each toxicity and a weighted risk scoring system was subsequently devised based on the magnitude of the parameter estimates in the multivariate model. Results: In total, 475 pts were included: median age was 62 years (range 26-89), 16.2% were aged >70 years, and 54.5% were men. The majority (90.1%) was ECOG 0/1. Independent predictors for nausea/vomiting included age >70 years (OR 2.46, 95%CI 1.3-4.8, p=0.011), GFR <50 (OR 1.68, 95% CI 1.1-2.7, p=0.025), and TTAC >8 weeks (OR 1.33, 95% CI 0.9-2.1, p=0.14) whereas independent predictors for diarrhea included age >70 years (OR 1.44, 95% CI 0.79-2.62, p=0.12) and GFR <50 (OR 1.67, 95% CI 1.1-2.6, p=0.018). The multivariate model for the risk of any GI toxicity included age >70 years (OR: 2.61, 95% CI 1.1-6.1, p=0.049), GFR <50 (OR 1.69, 95% CI 1.1-2.6, p=0.0038), and TTAC >8 weeks (OR 1.79, 95% CI 1.2-2.7, p=0.0059). Points were assigned: 2 points for long TTAC and poor GFR and 1 point for advanced age. The study cohort was classified into their risk groups based on their score (Table). Conclusions: We developed a simple 5-point scoring system to stratify early CC pts receiving adjuvant FOLFOX into low and high risk groups for GI toxicity based on baseline clinical factors. Further validation of this scoring system is required. [Table: see text]

Predictive Factors of Long-Term Rectal Toxicity Following I-125 Prostate Brachytherapy with or without External Beam Radiotherapy

Brachytherapy ◽  
2017 ◽  
Vol 16 (3) ◽  
pp. S18
Author(s):  
Atsunori Yorozu ◽  
Shinya Sutani ◽  
Ayumu Sunaguchi ◽  
Ryuichi Kota ◽  
Kazuhito Toya ◽  
...  
Keyword(s):  
Predictive Factors ◽  
External Beam Radiotherapy ◽  
Prostate Brachytherapy ◽  
External Beam ◽  
Rectal Toxicity

The difference in implantation quality between loose seed and variable spacing strand seeds in the field of prostate brachytherapy.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 252-252
Author(s):  
Pigné Grégoire ◽  
Pigné Grégoire ◽  
Tanguy Ronan ◽  
Ribouton Julien ◽  
Alain Ruffion ◽  
...  
Keyword(s):  
Clinical Results ◽  
Prostate Brachytherapy ◽  
Rectal Toxicity ◽  
Seed Implantation ◽  
Significant Difference ◽  
Variable Distance ◽  
The Difference ◽  
Iodine 125 ◽  
Post Implantation

252 Background: Concordance between intraoperative and postoperative dosimetry is a well-known marker of implant quality in prostate brachytherapy. The aim of the study was to evaluate if the use of variable distance strand seeds allows an improvement in the quality of the post implantation dosimetry. Methods: Before December 2010, an iodine 125 loose-seed technique was used for prostate brachytherapy. Since this date, patients have been treated with new variable distance strand seeds (ProLink; Bard). Post implant dosimetry was compared to intraoperative dosimetry in 30 patients treated with loose seeds and 29 patients treated with strand seeds. The prescribed dose was 145Gy. Variations of dosimetric parameters were used to set the two techniques against one another: prostate V100 and D90 and rectum V145 and V160. Results: There was a significant difference between intraoperative and postoperative V100 and D90 for all 59 patients: V100 preop-postop: mean 6,65% +/- SD 4,5; D90 preop-postop: 18,73Gy +/- SD 15 (p<0,0001). This dosimetric difference between pre and post-operative dosimetry is more important using loose seeds brachytherapy: V100 preop-postop: 9,5% +/- SD 4,1 vs 3,7% +/- SD 2,7 for loose seeds and strand seeds respectively (p<0,0001), and D90 preop-postop: 27,9Gy +/-SD 13,6 vs 9,2Gy +/- SD 9,7 for loose seeds and strand seeds respectively (p<0,0001). For V145 rectum and V160 rectum, dosimetric difference wasn't significant: V145 rectum preop-postop: -0,9% +/- SD 1,4 with stranded seeds vs. -1,6% +/- SD 2,1 with loose seeds (p=0,14) and V160 rectum pre-postop: -0,5% +/- SD 0,8 with strand seeds vs. -0,5% +/- SD 0,8 with loose seeds (p=0,16). Conclusions: Stranded seeds implantation increases the quality of implantation by reducing the dosimetric difference (V100 and D90) between intra and post-operative dosimetry to a maximum of 6% and 7% vs. more than 20% with loose seed implantation. Moreover, this technique doesn’t seem to modify the risk of rectal toxicity. This achievement in implantation and dosimetric quality might lead to a gain in clinical results.

Sign in / Sign up

Export Citation Format

Share Document