Acute toxicity after a diverting stoma and spacer prior to chemoradiation in locally advanced rectal cancer. Issue 1 (July 2015)

• Record Type: Journal Article
• Authors: van der Voort van Zyp, Jochem R.N.; Ceha, Heleen M.; Niehe, Valerie; Marinelli, Andreas W.K.S.; Putter, Hein; Marijnen, Corrie A.M.
• Is Part Of: Radiotherapy and oncology. Volume 116:Issue 1(2015:Jul.)
• Page Start: 107
• Page End: 111
• Publication Date: 2015-07
• Subjects: Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2015.06.001
• Languages: English
• ISSNs: 0167-8140

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st005">Abstract</title> <sec> <title id="st010">Background and purpose</title> <p id="sp0005">Chemoradiotherapy (CRT) followed by surgery is the standard of care for locally advanced rectal cancer (LARC). For grade ⩾3 acute diarrhea there is a relationship between dose and irradiated small bowel volume. The aim of this study was to evaluate whether combined placement of a diverting stoma and sigmoid spacer (DSSS) led to reduced irradiated small bowel volume and less grade ⩾3 acute diarrhea in the treatment of LARC.</p> </sec> <sec> <title id="st015">Materials/methods</title> <p id="sp0010">Between 2003 and 2010, 54 of 189 LARC patients treated with CRT in two institutions had a DSSS prior to CRT. Data on patient and treatment characteristics and outcomes were collected retrospectively. Delineation of small bowel was performed with planning CT-scans. CTCAE version 4.0 was used for acute toxicity.</p> </sec> <sec> <title id="st020">Results</title> <p id="sp0015">Patients with a DSSS had significantly less small bowel volume irradiated up to doses of 20 Gy. This difference was not observed for the higher dose levels. CRT induced grade ⩾3 acute diarrhea was not different between the two groups (8.3% vs. 12.8%; <italic>p</italic> = 0.41).</p> </sec> <sec> <title id="st025">Conclusion</title> <p id="sp0020">DSSS is not clearly beneficial to reduce grade ⩾3 acute diarrhea, and it must be considered whether placement of a DSSS is justified for this purpose.</p> </sec> </abstract>