P042 Inflammatory bowel disease is no longer a contraindication for radiation therapy: A systematic review of outcomes with modern RT techniques
Notice bibliographique
Résumé
BACKGROUND: Inflammatory bowel disease (IBD) continues to be considered a contraindication to the use of Radiation Therapy (RT). Oncologists are often unwilling to deliver RT, due to a perceived risk of severe bowel toxicity, or IBD exacerbation. Modern precision RT techniques allow significant reduction in dose to normal organs, and several studies have reported low toxicity rates. We performed a systematic review of recent studies to summarize the current evidence regarding RT toxicity in cancer patients with IBD. METHODS: MEDLINE and EMBASE databases were searched, using combinations of key terms, for relevant studies published over the past 10 years (2008–2018). Reference lists of eligible articles were also hand-searched. A total of 278 articles were screened, and 9 studies met our search criteria to be included in this review. RESULTS: From the 9 relevant studies, 198 patients with IBD, treated using radiation therapy, and with outcome data available, were included. The reported median follow-up was 55.2 months. The majority of patients (n = 148, 75%) were male; 113 (57%) had Ulcerative Colitis, 81 (41%) had Crohn's Disease, and 4 patients had IBD NOS. Nineteen patients (9.5%) were reported to have active IBD within 6 -12 months prior to starting RT. Colo-rectal carcinoma was the most common malignancy (n = 91, 46%), followed by prostate cancer (n = 83, 42%), anal-canal (n = 10, 5%), and gynecological malignancies (n = 6, 3%). External beam RT was used as part of treatment for 173 patients (87%), while 25 received brachytherapy alone. About 28% (n = 55) also received concurrent chemotherapy. From studies that reported the RT technique used, about 43% of patients were treated with Intensity Modulated RT (IMRT). RT dose ranged from 25 Gy/5 for pre-op rectal cancers to over 70 Gy for prostate cancers. Median BED (a/b = 3, rectum) was calculated to be 83.3 Gy. Acute toxicity data was available for 190 patients: clinically significant acute toxicity, ≥Grade 3, was reported in 29 patients (15.3%). Late RT toxicity data was available for 115 patients: ≥Grade 2 GI toxicity was reported in 21 (10.5%), and ≥Grade 3 in 7 (3.5%) of patients. CONCLUSION(S): With the use of modern RT techniques, GI toxicity is relatively low for patients with IBD, and is not numerically different from that reported for patients without IBD. Patient selection and meticulous RT planning is important, however, evidence does not suggest that IBD in itself is a contraindication for RT.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,004 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».