Meng Gan1, Dustin Boothe2, Deborah W Neklason3, N Jewel Samadder4, Jonathan Frandsen2, Megan B Keener3, Shane Lloyd2. 1. University of Utah School of Medicine; Salt Lake City, UT, USA. 2. Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah; Salt Lake City, UT, USA. 3. Department of Oncological Sciences, University of Utah; Salt Lake City, UT, USA. 4. Department of Internal Medicine, University of Utah; Salt Lake City, UT, USA.
Abstract
BACKGROUND: The outcomes, complications, and rates of secondary malignancies from radiation therapy (RT) are not known for patients with familial adenomatous polyposis (FAP). METHODS: We queried the Hereditary Gastrointestinal Cancer Registry (HGCR) for patients with FAP who received RT. Outcomes assessed included acute and late treatment toxicity and secondary malignancies. RESULTS: We identified 15 patients undergoing 18 treatment courses. Median follow-up was 3.1 years after RT. Treated sites included rectal cancer, desmoid, prostate cancer, breast cancer, melanoma, medulloblastoma, gastric cancer, and glioma. Secondary tumors occurred in two patients: a medulloblastoma was diagnosed in a patient treated for glioma, and a desmoid tumor was diagnosed in a patient treated for rectal cancer. All nine patients treated with intra-abdominal or pelvic RT had prior prophylactic proctocolectomies, yet only one patient experienced grade 3 gastrointestinal toxicity. Common Terminology Criteria for Adverse Events version 4 (CTCAE v4) toxicities were grade 1 in seven treatment courses (39%), grade 2 in five courses (28%), and grade 3 in two courses (11%). CONCLUSIONS: In this cohort, RT was well tolerated with adverse effects comparable with non-FAP patients. Secondary in-field tumors occurred in 2 of 15 patients and their increased risk in this cohort was likely due to prior predilection from FAP itself, although an increased role of RT cannot be ruled out.
BACKGROUND: The outcomes, complications, and rates of secondary malignancies from radiation therapy (RT) are not known for patients with familial adenomatous polyposis (FAP). METHODS: We queried the Hereditary Gastrointestinal Cancer Registry (HGCR) for patients with FAP who received RT. Outcomes assessed included acute and late treatment toxicity and secondary malignancies. RESULTS: We identified 15 patients undergoing 18 treatment courses. Median follow-up was 3.1 years after RT. Treated sites included rectal cancer, desmoid, prostate cancer, breast cancer, melanoma, medulloblastoma, gastric cancer, and glioma. Secondary tumors occurred in two patients: a medulloblastoma was diagnosed in a patient treated for glioma, and a desmoid tumor was diagnosed in a patient treated for rectal cancer. All nine patients treated with intra-abdominal or pelvic RT had prior prophylactic proctocolectomies, yet only one patient experienced grade 3 gastrointestinal toxicity. Common Terminology Criteria for Adverse Events version 4 (CTCAE v4) toxicities were grade 1 in seven treatment courses (39%), grade 2 in five courses (28%), and grade 3 in two courses (11%). CONCLUSIONS: In this cohort, RT was well tolerated with adverse effects comparable with non-FAPpatients. Secondary in-field tumors occurred in 2 of 15 patients and their increased risk in this cohort was likely due to prior predilection from FAP itself, although an increased role of RT cannot be ruled out.
Entities:
Keywords:
Familial cancer syndrome; adjuvant treatment; adverse effects; tumorigenesis
Authors: Brigitta G Baumert; Martin O Spahr; Arthur Von Hochstetter; Sylvie Beauvois; Christine Landmann; Katrin Fridrich; Salvador Villà; Michael J Kirschner; Guy Storme; Peter Thum; Hans K Streuli; Norbert Lombriser; Robert Maurer; Gerhard Ries; Ernst-Arnold Bleher; Alfred Willi; Juerg Allemann; Ulrich Buehler; Hugo Blessing; Urs M Luetolf; J Bernard Davis; Burkhardt Seifert; Manfred Infanger Journal: Radiat Oncol Date: 2007-03-07 Impact factor: 3.481