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Defining bowel dose volume constraints for bladder radiotherapy treatment planning
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McDonald, F., Waters, R., Gulliford, S., Hall, E., James, Nicholas D. and Huddart, R. A. (2015) Defining bowel dose volume constraints for bladder radiotherapy treatment planning. Clinical Oncology, Volume 27 (Number 1). pp. 22-29. doi:10.1016/j.clon.2014.09.016 ISSN 0936-6555.
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Official URL: http://dx.doi.org/10.1016/j.clon.2014.09.016
Abstract
Aims
Increases to radiotherapy dose are constrained by normal tissue effects. The relationship between bowel dose volume data and late bowel toxicity in patients with muscle-invasive bladder cancer treated with radical radiotherapy was assessed.
Materials and methods
The bowel was contoured retrospectively on radiotherapy plans of 47 patients recruited to the BC2001 trial (CRUK/01/004). The relationship between bowel volume at various dose levels and prospectively collected late bowel toxicity was explored.
Results
Fifteen per cent and 6% of patients experienced grade 1 and grade 2 or more late bowel toxicity, respectively. The mean bowel volume was significantly less at doses ≥50 Gy in those treated with reduced high dose volume radiotherapy compared with standard radiotherapy. The probability of late bowel toxicity increased as bowel volume increased (P ≤ 0.05 for dose levels 30–50 Gy). No grade 2 or more late bowel toxicity was observed in patients with bowel volumes under the thresholds given in the model that predict for 25% probability of late bowel toxicity.
Conclusions
There is a dose volume effect for late bowel toxicity in radical bladder radiotherapy. We have modelled the probability of late bowel toxicity from absolute bowel volumes to guide clinicians in assessing radical bladder radiotherapy plans. Thresholds predicting for a 25% probability of late bowel toxicity are proposed as dose volume constraints.
Item Type: | Journal Article | ||||||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Cancer Research Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Clinical Oncology | ||||||||||
Publisher: | Elsevier Science London | ||||||||||
ISSN: | 0936-6555 | ||||||||||
Official Date: | January 2015 | ||||||||||
Dates: |
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Volume: | Volume 27 | ||||||||||
Number: | Number 1 | ||||||||||
Page Range: | pp. 22-29 | ||||||||||
DOI: | 10.1016/j.clon.2014.09.016 | ||||||||||
Status: | Peer Reviewed | ||||||||||
Publication Status: | Published | ||||||||||
Access rights to Published version: | Restricted or Subscription Access |
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