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dc.contributor.authorMarcello, M
dc.contributor.authorDenham, JW
dc.contributor.authorKennedy, A
dc.contributor.authorHaworth, A
dc.contributor.authorSteigler, A
dc.contributor.authorGreer, PB
dc.contributor.authorHolloway, LC
dc.contributor.authorDowling, JA
dc.contributor.authorJameson, MG
dc.contributor.authorRoach, D
dc.contributor.authorJoseph, DJ
dc.contributor.authorGulliford, SL
dc.contributor.authorDearnaley, DP
dc.contributor.authorSydes, MR
dc.contributor.authorHall, E
dc.contributor.authorEbert, MA
dc.date.accessioned2020-08-24T09:00:00Z
dc.date.issued2020-09
dc.identifier.citationRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2020, 150 pp. 281 - 292
dc.identifier.issn0167-8140
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3993
dc.identifier.eissn1879-0887
dc.identifier.doi10.1016/j.radonc.2020.07.048
dc.description.abstractBackground and purpose This study aimed to identify anatomically-localised regions where planned radiotherapy dose is associated with gastrointestinal toxicities in healthy tissues throughout the pelvic anatomy.Materials and methods Planned dose distributions for up to 657 patients of the Trans Tasman Radiation Oncology Group 03.04 RADAR trial were deformably registered onto a single exemplar computed tomography dataset. Voxel-based multiple comparison permutation dose difference testing, Cox regression modelling and LASSO feature selection were used to identify regions where dose-increase was associated with grade ≥2 rectal bleeding (RB) or tenesmus, according to the LENT/SOMA scale. This was externally validated by registering dose distributions from the RT01 (n = 388) and CHHiP (n = 241) trials onto the same exemplar and repeating the tests on each of these data sets, and on all three datasets combined.Results Voxel-based Cox regression and permutation dose difference testing revealed regions where increased dose was correlated with gastrointestinal toxicity. Grade ≥2 RB was associated with posteriorly extended lateral beams that manifested high doses (>55 Gy) in a small rectal volume adjacent to the clinical target volume. A correlation was found between grade ≥2 tenesmus and increased low-intermediate dose (∼25 Gy) at the posterior beam region, including the posterior rectum and perirectal fat space (PRFS).Conclusions The serial response of the rectum with respect to RB has been demonstrated in patients with posteriorly extended lateral beams. Similarly, the parallel response of the PRFS with respect to tenesmus has been demonstrated in patients treated with the posterior beam.
dc.formatPrint-Electronic
dc.format.extent281 - 292
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://www.rioxx.net/licenses/under-embargo-all-rights-reserved
dc.titleRelationships between rectal and perirectal doses and rectal bleeding or tenesmus in pooled voxel-based analysis of 3 randomised phase III trials.
dc.typeJournal Article
dcterms.dateAccepted2020-07-28
rioxxterms.versionofrecord10.1016/j.radonc.2020.07.048
rioxxterms.licenseref.urihttps://www.rioxx.net/licenses/under-embargo-all-rights-reserved
rioxxterms.licenseref.startdate2020-09
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/ICR-CTSU Urology and Head and Neck Trials Team
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Radiotherapy Physics Modelling
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/ICR-CTSU Urology and Head and Neck Trials Team
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Radiotherapy Physics Modelling
pubs.publication-statusPublished
pubs.volume150
pubs.embargo.termsNot known
icr.researchteamICR-CTSU Urology and Head and Neck Trials Teamen_US
icr.researchteamClinical Academic Radiotherapy (Dearnaley)en_US
icr.researchteamRadiotherapy Physics Modellingen_US
dc.contributor.icrauthorGulliford, Sarahen
dc.contributor.icrauthorDearnaley, Daviden
dc.contributor.icrauthorHall, Emmaen


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