Jp. Gerard et al., PREVENTION OF RADIATION RELATED COMPLICATIONS IN THE TREATMENT OF RECTAL ADENOCARCINOMA - THE IMPORTANCE OF THE DOSE VOLUME RELATIONSHIP, Tumori, 81(3), 1995, pp. 114-116
Aim: To illustrate and stress the role of the dose volume relationship
in the risk of radiation induced rectal complications. Methods: With
different techniques of irradiation like contact x ray therapy, Iridiu
m implant, external beam irradiation, intra operative electrontherapy,
it is possible to irradiate different volumes from few centicubes to
liters. Results: The data from the literature clearly demonstrate that
high doses can be given safely in small volumes, but that doses of 50
Gy or more in large volumes are dangerous. The irradiation of the who
le pelvis through two antero posterior (AP - PA) fields ecompassing mo
re than 4 liters should not be recommended. Other classical risk facto
rs must be taken into account when planning the treatment. Previous su
rgery, obesity, diabetus, collagen disease, combined chemotherapy, all
these factors can lead to a modification of the irradiation technique
. Conclusions: A perfect technique of irradiation is mandatory to achi
eve the best therapeutic ratio when treating rectal cancer. To avoid s
evere complications the dose must be closely adapted to the irradiated
volume.