Outcomes and complications of radiation therapy in patients with familial adenomatous polyposis

Meng Gan, Dustin Boothe, Deborah W. Neklason, N. Jewel Samadder, Jonathan Frandsen, Megan B. Keener, Shane Lloyd

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: The outcomes, complications, and rates of secondary malignancies from radiation therapy (RT) are not known for patients with familial adenomatous polyposis (FAP). Methods: We queried the Hereditary Gastrointestinal Cancer Registry (HGCR) for patients with FAP who received RT. Outcomes assessed included acute and late treatment toxicity and secondary malignancies. Results: We identified 15 patients undergoing 18 treatment courses. Median follow-up was 3.1 years after RT. Treated sites included rectal cancer, desmoid, prostate cancer, breast cancer, melanoma, medulloblastoma, gastric cancer, and glioma. Secondary tumors occurred in two patients: a medulloblastoma was diagnosed in a patient treated for glioma, and a desmoid tumor was diagnosed in a patient treated for rectal cancer. All nine patients treated with intra-abdominal or pelvic RT had prior prophylactic proctocolectomies, yet only one patient experienced grade 3 gastrointestinal toxicity. Common Terminology Criteria for Adverse Events version 4 (CTCAE v4) toxicities were grade 1 in seven treatment courses (39%), grade 2 in five courses (28%), and grade 3 in two courses (11%). Conclusions: In this cohort, RT was well tolerated with adverse effects comparable with non-FAP patients. Secondary in-field tumors occurred in 2 of 15 patients and their increased risk in this cohort was likely due to prior predilection from FAP itself, although an increased role of RT cannot be ruled out.

Original languageEnglish (US)
Pages (from-to)643-649
Number of pages7
JournalJournal of Gastrointestinal Oncology
Issue number4
StatePublished - Aug 1 2017


  • Adjuvant treatment
  • Adverse effects
  • Familial cancer syndrome
  • Tumorigenesis

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology


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