Acute and late radiotherapy toxicity in patients with inflammatory bowel disease

Purpose: To evaluate the incidence of gastrointestinal complications in pat ients with inflammatory bowel disease (IBD) receiving radiotherapy (RT) and to identify possibly avoidable factors associated with these complications . Methods and Materials: Twenty-four patients were identified and their recor ds reviewed; all had a history of IBD before receiving RT to fields encompa ssing some portion of the gastrointestinal tract (Crohn's disease) or to th e abdomen or pelvis (ulcerative colitis or IBD not otherwise specified). Results: Five of 24 patients (21%) experienced Grade greater than or equal to3 acute gastrointestinal toxicity; all 5 received concurrent chemotherapy . Two of 24 patients (8%) experienced Grade greater than or equal to3 late gastrointestinal toxicity. There were no significant correlations between c omplications and IBD type, prior IBD-related surgery, use of medications fo r IBD, or status of IBD. Conclusion: Patients with IBD may have an increased risk for severe acute R T-related gastrointestinal complications that is more modest than generally perceived, because all patients who had Grade greater than or equal to3 ac ute complications in this study had received concurrent chemotherapy (p = 0 .04). Further study is needed to assess this risk, as well as the impact of RT on these patients' future gastrointestinal morbidity. (C) 2001 Elsevier Science Inc.