IMRT limits nephrotoxicity after chemoradiotherapy for gastric cancer

Anouk Kirsten Trip, Jasper Nijkamp, Harm Van Tinteren, Annemieke Cats, Henk Boot, Edwin Petrus Marianus Jansen, Marcel Verheij

Onderzoeksoutput: Bijdrage aan tijdschriftArtikelpeer review

25 Citaten (Scopus)


Objective This observational study compares the effect of different radiotherapy techniques on late nephrotoxicity after postoperative chemoradiotherapy for gastric cancer.

Patients and methods Dosimetric parameters were compared between AP-PA, 3D-conformal and IMRT techniques. Renal function was measured by 99mTc-MAG-3 renography, glomerular filtration rate (GFR) and the development of hypertension. Mixed effects models were used to compare renal function over time.

Results Eighty-seven patients treated between 2002 and 2010 were included, AP-PA (n = 31), 3D-conformal (n = 25) and IMRT (n = 31), all 45 Gy in 25 fractions. Concurrent chemotherapy: 5FU/leucovorin (n = 4), capecitabine (n = 37), and capecitabine/cisplatin (n = 46). Median follow-up time was 4.7 years (range 0.2-8). With IMRT, the mean dose to the left kidney was significantly lower. Left kidney function decreased progressively in the total study population, however with IMRT this occurred at a lower rate. A dose-effect relationship was present between mean dose to the left kidney and the left kidney function. GFR decreased only moderately in time, which was not different between techniques. Six patients developed hypertension, of whom none in the IMRT group.

Conclusions This study confirms progressive late nephrotoxicity in patients treated with postoperative chemoradiotherapy by different techniques for gastric cancer. Nephrotoxicity was less severe with IMRT and should be considered the preferred technique.

Originele taal-2Engels
Pagina's (van-tot)289-294
Aantal pagina's6
TijdschriftRadiotherapy and Oncology
Nummer van het tijdschrift2
StatusGepubliceerd - 1 aug. 2014
Extern gepubliceerdJa


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