Tolerance and acute toxicity
Overall, weight-loss was noted in 30 patients during the treatment with
a median weight-loss of 0.95Kg (0.1-10.5kg corresponding to 0.15-10.9%
of body weight). 17 patients gained weight during the treatment with a
median of 0.9kg (0.1-5.3Kg or 0.5-21.7%). Table 3 depicts acute
toxicities noted in CNS and non-CNS tumors. Most common acute toxicity
noted irrespective of the site of irradiation was radiation dermatitis.
21 patients (45%) had grade 2 dermatitis and only 1 patient (2%) had
grade 3 dermatitis (13-year child with nasopharyngeal carcinoma who
received 70Gyto bilateral neck). 18 patients (38%) had grade> 2 and 14 patients (30%) had grade> 3 hematological toxicities of which 12 patients
(26%) had grade > 3 neutropenia. None of the
patients developed grade 3 mucositis or dysphagia which mandated a need
for feeding tube during treatment.
On univariate analysis (Chi-square test) of patients with CNS tumors,
concurrent chemotherapy (p=0.009), CSI (p<0.001)and volume of
CTVwere associated with > 2 grade hematological
toxicity[Table 4]. On multivariate analysis both concurrent
chemotherapy (p=) and CSI (p) were independently associated
with> 2 grade hematological toxicity.
Among non-CNS tumors, on univariate analysis CTV>150cc was
significantly associated with > 2grade fatigue
(p=0.017), head neck irradiation (p=0.01) was associated with> 2 grade mucositis and concurrent
chemotherapy(p=0.02) was associated with grade > 2
hematological toxicity. The same were found significant on multivariate
analysis. (p=0.05, p=0.03 and p=0.01 respectively)