Intensity modulated radiation therapy reduces gastrointestinal XXXX in locally advanced @entity788 .

@entity1 @entity788 @entity137 @entity146 @entity5 @entity344 @entity1503 @entity136 @entity1487
PURPOSE: We compared gastrointestinal (GI) and @entity1503 in @entity1 with locally advanced @entity788 (LAPC) undergoing definitive chemoradiation using intensity modulated radiation therapy (IMRT) or 3-dimensional conformal radiation therapy (3D-CRT) planning. METHODS AND MATERIALS: We retrospectively studied 205 @entity1 with LAPC undergoing IMRT (n = 134) and 3D-CRT (n = 71) between May 2003 and March 2012. @entity1 , @entity5 , and treatment characteristics and acute GI/hematology @entity137 according to the Common Terminology Criteria for Adverse Events, version 3.0, were recorded. Multivariable logistic regression models were used to test association between acute grade 2+ GI and @entity1503 outcomes and predictors. Propensity score analysis for grade 2+ @entity344 was performed to reduce bias for confounding variables: age, gender, radiation dose, field size, and chemotherapy type. RESULTS: Median follow-up time for survivors was 22 months and was similar between groups. Median RT dose was significantly higher for IMRT versus 3D-CRT (5600 cGy vs 5040 cGy, P < .001); concurrent chemotherapy was mainly @entity136 (56%) or @entity1487 (38%). Grade 2+ @entity344 occurred in 34% (n = 24) of 3D-CRT compared with 16% (n = 21) of IMRT @entity1 . Using propensity score analysis, 3D-CRT had significantly higher grade 2+ @entity344 (odds ratio, 1.26; 95% confidence interval, 1.08-1.45; P = .001). Grade 2+ @entity1503 was similar between IMRT and 3D-CRT groups, but was significantly greater in recipients of concurrent @entity136 than in @entity1487 (62% vs 29%, P < .0001). CONCLUSIONS: IMRT is associated with significant lower grade 2+ @entity344 versus 3D-CRT for @entity1 undergoing definitive chemoradiation therapy for LAPC. Because IMRT is better tolerated at higher doses and may allow further dose escalation, potentially improving local control for this @entity146 . Further prospective studies of dose-escalated chemoradiation using IMRT are warranted.
