Comparison of changes in renal function with dosimetric parameters in gastric cancer patients treated with adjuvant chemoradiotherapy

Purpose

Our objective was to analyze kidney damage using glomerular filtration rate (GFR) and dynamic renal scintigraphy (DRS) compared with dose volume histogram (DVH) parameters in gastric cancer patients.

Materials and methods

Twenty-two gastric cancer patients treated with postoperative chemoradiotherapy were retrospectively evaluated. Student’s t test was used to compare pre- and posttreatment GFR and creatinine values. The relative contribution of the left and right kidney in DRS results was expressed as left-to-right ratio (L/R), and the percentage of initial and control participation ratio difference was calculated. Spearman’s correlation analysis was used to compare the percentage difference of L/R ratio with DVH parameters of each kidney.

Results

In DRS analysis, decrease in left kidney cortical function was observed in one patient. V5–V10 of the left and bilateral kidneys were significantly associated with GFR decline. None of the DVH parameter was significantly associated with L/R ratio. However, the V15 and D_mean of the bilateral kidney were significantly correlated with greater decrease in L/R ratio in seven patients whose posttreatment DRS period was > 12 months.

Conclusions

Decline in renal function, even with current renal constraints, was observed. Minimization of V5, V10, and V15 and mean dose (D_mean) to the kidney should be considered.