Acute toxicity after a diverting stoma and spacer prior to chemoradiation in locally advanced rectal cancer

作者：van Zyp Jochem R N van der Voort; Ceha Heleen M; Niehe Valerie; Marinelli Andreas W K S; Putter Hein; Marijnen Corrie A M^*

来源：Radiotherapy and Oncology, 2015, 116(1): 107-111.

DOI：10.1016/j.radonc.2015.06.001

• Rectal cancer
• Chemoradiotherapy
• Toxicity
• Diverting stoma
• Spacer
• Small bowel

Background and purpose: 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.
Materials/methods: 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.
Results: 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%; p = 0.41).
Conclusion: 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.

• 出版日期2015-7