Does acute gastrointestinal toxicity during radical pelvic radiotherapy predict late gastrointestinal toxicity? A study using the IBDQ and a Vaizey score, more sensitive measures of radiotherapy-induced toxicity than the RTOG or LENT SOM scales
Year: 2008
Session type: Poster / e-Poster / Silent Theatre session
Royal Marsden Hospital, London, UK
Abstract
Background
Current scales for measuring gastrointestinal toxicity during pelvic radiotherapy are inadequate and underestimate morbidity. As a result it is not clear whether there is a consequential effect between acute toxicity and the development of significant late toxicity.
Aim
A prospective study to define whether acute toxicity predisposes to late toxicity using modified Inflammatory Bowel Disease Questionnaire and Vaizey scores weekly during radiotherapy and at one year after treatment.
Method
Patients undergoing radical radiotherapy for pelvic cancer were assessed for toxicity at baseline, weekly during treatment and one year after treatment, using RTOG, IBDQ and Vaizey questionnaires. Acute toxicity scores were compared to toxicity at one year.
Results
309 patients (67 colorectal, 105 gynaecological, 136 urological) median age 64 years (range 23-86) about to undergo radical radiotherapy to a pelvic tumour were recruited. The mean worst IBDQ score was 182.6 (s.e. 2.3) and mean worst Vaizey was 7.5 (s.e. 0.3)
209 patients were available for follow up at one year. 102 (50%) had toxicity at one year (defined as Vaizey>5, or IBDQ<200). After controlling for disease site (significantly associated with late toxicity with p<0.001, chi squared test, worst in colorectal, best in urological), all measures of acute toxicity were predictive of late toxicity using binary logistic regression, but the best model fit was obtained using worst Vaizey score and IBDQ AUC combined.
Conclusion
The occuranceof acute toxicity is a significant predictor of late toxicity at one year post-treatment. Both Vaizey and IBDQ scores are useful measures of acute toxicity.
Background
Current scales for measuring gastrointestinal toxicity during pelvic radiotherapy are inadequate and underestimate morbidity. As a result it is not clear whether there is a consequential effect between acute toxicity and the development of significant late toxicity.
Aim
A prospective study to define whether acute toxicity predisposes to late toxicity using modified Inflammatory Bowel Disease Questionnaire and Vaizey scores weekly during radiotherapy and at one year after treatment.
Method
Patients undergoing radical radiotherapy for pelvic cancer were assessed for toxicity at baseline, weekly during treatment and one year after treatment, using RTOG, IBDQ and Vaizey questionnaires. Acute toxicity scores were compared to toxicity at one year.
Results
309 patients (67 colorectal, 105 gynaecological, 136 urological) median age 64 years (range 23-86) about to undergo radical radiotherapy to a pelvic tumour were recruited. The mean worst IBDQ score was 182.6 (s.e. 2.3) and mean worst Vaizey was 7.5 (s.e. 0.3)
209 patients were available for follow up at one year. 102 (50%) had toxicity at one year (defined as Vaizey>5, or IBDQ<200). After controlling for disease site (significantly associated with late toxicity with p<0.001, chi squared test, worst in colorectal, best in urological), all measures of acute toxicity were predictive of late toxicity using binary logistic regression, but the best model fit was obtained using worst Vaizey score and IBDQ AUC combined.
Conclusion
The occuranceof acute toxicity is a significant predictor of late toxicity at one year post-treatment. Both Vaizey and IBDQ scores are useful measures of acute toxicity.
