Hautmann, Matthias G. and Dietl, Barbara and Wagner, Laura and Zeman, Florian and Koelbl, Oliver and Pfister, Karin and Schierling, Wilma (2021) Radiation Therapy of Lymphatic Fistulae After Vascular Surgery in the Groin. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 111 (4). pp. 949-958. ISSN 0360-3016, 1879-355X
Full text not available from this repository. (Request a copy)Abstract
Purpose: Lymphatic fistulas are common complications after vascular surgery, especially in the groin, and can lead to a prolongation of the inpatient stay, wound infections, and follow-up operations. Radiation therapy is one of the nonsurgical treatment options; however, evidence and discussion about the ideal dosage and timing are limited. Methods and Materials: The analysis was performed on patients from a German university hospital and included 191 patients with 206 lymphatic fistulas from 2005 to 2016. Four different endpoints were analyzed. The patients were irradiated with a fraction dose of 3 Gy up to a cumulative dose of 9 Gy (94 cases) or 18 Gy (112 cases). The median age of the patients was 70.5 years; 74% were male and 26% were female. Vascular surgery included bypass grafts (52%), thromboendarterectomy/ patch angioplasty (26%), and vascular access for aortic endografts (22%). Results: The response to radiation therapy for the 4 different endpoints was 88% (25% decrease in secretion volume), 80% (secretion <50 mL per 24 hours), 81% (removal of the drainage), and 75% (freedom from any intervention). The overall response for all 4 endpoints was 63% (129 of 206) after completion of radiation therapy and 34% (70 of 206) after 1 course with a total dose up to 9 Gy. The median lymphatic secretion was 150 mL per 24 hours before radiation therapy and 60 mL per 24 hours 1 day after the end of therapy. The drainage could be removed a median of 3 days after radiation therapy completion. There was no significant difference between patients starting the radiation within 5 to 9 days or >= 10 days postoperatively (P = .971; OR, 0.99; 95% confidence interval, 0.56-1.74). No relevant factors influencing the response rate could be identified. Reoperation was required in 50 of the 206 cases (25%): 24 (12%) owing to persistent lymphatic fistula and complications and 26 (13%) owing to wound and/or vascular complications. Conclusions: Radiation therapy seems to be an effective nonsurgical treatment option for reducing lymphatic secretion after vascular surgery in the groin. Starting radiation early (<= 9 days) or late (>10 days) postoperatively did not affect the success rate. (C) 2021 Elsevier Inc. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PAINFUL HEEL SPUR; ARTERIAL RECONSTRUCTION; DOXYCYCLINE TREATMENT; RADIOTHERAPY; MANAGEMENT; INCISION; CANCER; FLAPS; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Strahlentherapie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Jul 2022 07:09 |
| Last Modified: | 06 Jul 2022 07:09 |
| URI: | https://pred.uni-regensburg.de/id/eprint/45641 |
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