Int J Radiat Oncol Biol Phys. 2015 Jul 1;92(3):568-76. doi: 10.1016/j.ijrobp.2015.02.016.

Gastrointestinal Toxicities With Combined Antiangiogenic and Stereotactic Body Radiation Therapy.

Pollom EL¹, Deng L¹, Pai RK², Brown JM¹, Giaccia A¹, Loo BW Jr¹, Shultz DB¹, Le QT¹, Koong AC¹, Chang DT³.

Author information

1: Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California.
2: Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
3: Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California. Electronic address: dtchang@stanford.edu.

Abstract

Combining the latest targeted biologic agents with the most advanced radiation technologies has been an exciting development in the treatment of cancer patients. Stereotactic body radiation therapy (SBRT) is an ablative radiation approach that has become established for the treatment of a variety of malignancies, and it has been increasingly used in combination with biologic agents, including those targeting angiogenesis-specific pathways. Multiple reports have emerged describing unanticipated toxicities arising from the combination of SBRT and angiogenesis-targeting agents, particularly of late luminal gastrointestinal toxicities. In this review, we summarize the literature describing these toxicities, explore the biological mechanism of action of toxicity with the combined use of antiangiogenic therapies, and discuss areas of future research, so that this combination of treatment modalities can continue to be used in broader clinical contexts.