The tolerance of gastrointestinal organs to stereotactic body radiation therapy: What do we know so far?

Tarita O. Thomas, Shaakir Hasan, William Small, Joseph M. Herman, Michael Lock, Edward Y. Kim, Nina A. Mayr, Bin S. Teh, Simon S. Lo

Research output: Contribution to journalReview article

Abstract

As stereotactic body radiation therapy (SBRT) for gastrointestinal (GI) gains popularity, there is a need to optimize doses and fractionation to minimize GI toxicity. GI organs that have classically developed radiation-induced toxicity include the liver & biliary system, small bowel, esophagus, and rectum. While the literature quantifies dose restrictions for these organs under standard fractionation, there is limited data regarding toxicity with the ablative dose schedules used in SBRT. We conducted a review of the literature to identify prospective and retrospective studies that detail GI toxicities when SBRT was employed. Based on the literature, the median SBRT dose for abdominal and thoracic tumors ranged from 24 to 60 Gy, at 5 to 25 Gy per fraction. The respective observed frequencies of grade 3 and 4 toxicities for the liver, biliary system, small bowel, and esophagus were variable among different studies. Typically, patients who suffered grade 3 and 4 toxicities were more likely to have had some form of systemic therapy as well. The effect of dose, fractionation, timing, and volume on GI toxicities has been described in the literature but more data is necessary to develop uniform treatment guidelines for SBRT.

Original languageEnglish (US)
Pages (from-to)236-246
Number of pages11
JournalJournal of Gastrointestinal Oncology
Volume5
Issue number3
DOIs
StatePublished - Jan 1 2014

Keywords

  • Gastrointestinal organs (GI organs)
  • Stereotactic body radiation therapy (SBRT)
  • Tolerance

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Fingerprint Dive into the research topics of 'The tolerance of gastrointestinal organs to stereotactic body radiation therapy: What do we know so far?'. Together they form a unique fingerprint.

  • Cite this

    Thomas, T. O., Hasan, S., Small, W., Herman, J. M., Lock, M., Kim, E. Y., Mayr, N. A., Teh, B. S., & Lo, S. S. (2014). The tolerance of gastrointestinal organs to stereotactic body radiation therapy: What do we know so far? Journal of Gastrointestinal Oncology, 5(3), 236-246. https://doi.org/10.3978/j.issn.2078-6891.2014.024