The therapeutic and adverse effects of modified radiation fields for patients with rectal cancer

Clin Colorectal Cancer. 2012 Dec;11(4):255-62. doi: 10.1016/j.clcc.2012.06.001. Epub 2012 Jul 3.

Abstract

Purpose: To compare the therapeutic effect and complications of modified radiation fields (MRFs) with those of conventional pelvic radiation fields (CPRFs) for rectal cancer.

Methods and materials: From December 1996 to October 2009, a total of 160 patients with rectal carcinoma who received total mesorectal excision and postoperative radiotherapy were examined. Ninety-four patients were in the CPRFs group, and 66 were in the MRFs group. The dose was 50 Gy per 25 fractions in the initial plan.

Results: The treatment volume and the volume of small bowel that received more than 15 Gy of the MRFs was smaller than that of the CPRFs (P < .001). The rates of local recurrence, overall survival, and disease-free survival were not statistically significant between the MRFs and CPRFs groups (P > .05). There was a statistical difference (P < .05) in the incidence of acute toxicity, which included serious complications in the lower digestive tract (grade ≥3). The completion rate for the initial radiotherapy plan was higher in the MRFs group than in the CPRFs group (P = .027).

Conclusions: Compared with CPRFs, MRFs manifested a lower incidence of complications and the same therapeutic effects. This finding will facilitate the clinical application of MRFs for patients with rectal cancer.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / radiotherapy*
  • Adenocarcinoma, Mucinous / mortality
  • Adenocarcinoma, Mucinous / pathology
  • Adenocarcinoma, Mucinous / radiotherapy*
  • Adenocarcinoma, Papillary / mortality
  • Adenocarcinoma, Papillary / pathology
  • Adenocarcinoma, Papillary / radiotherapy*
  • Aged
  • Carcinoma, Signet Ring Cell / mortality
  • Carcinoma, Signet Ring Cell / pathology
  • Carcinoma, Signet Ring Cell / radiotherapy*
  • Dose Fractionation, Radiation*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / radiotherapy*
  • Neoplasm Staging
  • Pelvis / radiation effects*
  • Prognosis
  • Radiotherapy Planning, Computer-Assisted
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / radiotherapy*
  • Survival Rate
  • United States