Complications from large field intermediate dose infradiaphragmatic radiation: an analysis of the patterns of care outcome studies for @entity978 and XXXX .

@entity1 @entity1310 @entity548 @entity5 @entity294 @entity344 @entity1583 @entity1321 @entity4797 @entity978 @entity99 @entity130
There are only infrequent complications from intermediate dose infradiaphragmatic radiation to the para-aortics or para-aortic and iliac nodal regions as given in @entity978 or @entity4797 . Nonetheless, such complications can cause significant debility and may be lifelong. Treatment related factors associated with such complications should be identified and where possible, avoided. We have analyzed the records of 1,026 @entity1 treated nationwide in the Patterns of Care Outcome. Studies including the Hodgkin's national practice survey (387 @entity1 ), Hodgkin's large facility survey (253 @entity1 ), and @entity4797 national practice survey (386 @entity1 ). There were 883 @entity1 who received infradiaphragmatic radiation to the para-aortics or para-aortic and iliac regions. Complications which occurred in these @entity1 included @entity344 , @entity99 , @entity1310 , @entity130 , @entity1583 , second @entity5 , and miscellaneous others. There were 139 complications of any severity and 35 major complications requiring hospitalization for management. The 3-year actuarial complication rates were 14% and 4% for any and major complications, respectively. There was a statistically significant increase in both any complications and major complications with dose (p less than .01). The most frequent complications were those related to @entity344 such as peptic ulceration, @entity548 , @entity294 , and @entity1321 . Major bowel complications comprised 60% (21/35) of major complications and increased with dose from 1% for doses less than 3,500 cGy to 3% for doses greater than or equal to 3,500 cGy (p = .03). This study indicates that total dose is an important factor in determining complications, particularly @entity344 , in @entity1 receiving infradiaphragmatic radiation in @entity978 and @entity4797 and that prior G.I. disease is associated with an increased risk of radiation related bowel complication. The radiotherapist should seek to optimize the therapeutic ratio in these diseases where gross disease can be controlled with 3500 cGy or less with few exceptions.
