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• W2141004055 abstract "There is limited data available on renal effects using modern radiation (RT) planning and treatment techniques. This study evaluated patients who received concurrent chemotherapy and abdominal radiation for subsequent change in renal size. Patients who received concurrent chemoradiation to abdomen between 2002 and 2008 were identified for this study evaluating change in renal size and function following RT. Imaging and biochemical data were obtained prior to and after RT. Renal size was defined by craniocaudal measurement on CT images. Renal function was assessed by creatinine clearance using the Cockcroft-Gault formula. The kidney that received the greater mean kidney dose was defined as the primarily irradiated kidney (PK). Receiver operating characteristic (ROC) curves, plots of sensitivity (true positive rate) versus 1 - specificity (false positive rate) for a collection of cut points, were generated to predict risk for renal atrophy. The approximate area under the curve (AUC) for each ROC plot was estimated to assess the predictive ability of dose volume parameters for renal atrophy. An AUC of 1.0 indicates perfect discriminatory ability. Of 130 patients, median age was 64 years and 51.5% were male. Majority of primary disease sites were pancreas and periampullary tumors (77.7%). Median radiation dose was 50.4 Gy. Mean dose to the PK was 18.6 Gy. One year following RT, mean size of PK decreased from 105.02 mm preRT to 100.88 mm, p < 0.0001. Compensatory hypertrophy of the non-PK was not seen. Creatinine clearance declined from 91.09 ml/min preRT to 77.61 ml/min over the same time period, p < 0.0001. Age, gender, hypertension, diabetes, smoking, chemotherapy, preRT creatinine clearance, and preRT renal size were not associated with renal atrophy postRT. Percent volumes of the PK receiving ≥10 Gy (V10), V15, and V20 were significantly associated with renal atrophy (p = 0.0030, 0.0029, and 0.0028 respectively). AUC for V10, V15, and V20 to predict>5% decrease in PK size were 0.760, 0.760, and 0.762. Using V15 ROC plot, a cut off for V15 of 50% was predictive for risk of developing renal atrophy with 80% sensitivity and 70% specificity. To our knowledge, this is the first report applying ROC curve analyses to predict radiation-induced kidney complications. Significant decline in PK size and renal function were seen following abdominal chemoradiation. The areas under the ROC curves in this study suggest that larger volumes of kidneys irradiated to lower doses (V10, V15, or V20 Gy) may be as important in predicting adverse events as smaller volumes treated to higher doses. The significance of lower dose renal irradiation on late effects has potential implications for RT delivery techniques such as IMRT and arc therapy in the abdomen." @default.
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• W2141004055 date "2009-11-01" @default.
• W2141004055 modified "2023-10-16" @default.
• W2141004055 title "Renal Atrophy Secondary to Abdominal Chemoradiotherapy: Receiver Operating Characteristic (ROC) Analysis" @default.
• W2141004055 doi "https://doi.org/10.1016/j.ijrobp.2009.07.605" @default.
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