Postoperative radiation for prevention of heterotopic ossification of the elbow: primary or secondary prophylaxis? In regard to Robinson CG et al. (Int J Radiat Oncol Biol Phys 2010;77:1493-1499).

摘要

We read the paper wrote by Dr. Kidd et al. with high interest (1). It was the first clinical report about the intensity-modulated radiotherapy (IMRT) technique used for treating a large scale of patients with cervical cancer for curative intent. It also had a 3-year follow-up and non-IMRT control result. However, there is a lack of clarity in three items. 1. It seems that the differences of overall survival and cause-specific survival in two groups are not related with the radiation technique, because the difference of pelvic recurrence is not significant (18/135 [13.3%] vs. 61/317 [19.2%], p > 0.05] and the tumor volume in two of the groups is not clear.2. Although the Grade 3 or greater complications are lower in the IMRT group (4%) than in no-IMRT group (17%), the Radiation Therapy Oncology Group Grade 2 complications also obviously affect the life quality of patients. 3. How about the relationship between the dose at organs at risk reference point and the complication? Is there a threshold for harmless dose to organs at risk in present study as in many other studies (2)?