Table 1.

Clinical reports of luminal GI toxicity with SBRT and hypofractionated radiation therapy and anti-VEGF agents

Study	Patient	% of patients treated with anti-VEGF agent and SBRT	Radiation schedule	Anti-VEGF agent	Toxicity	In-field toxicity?
Peters et al (30)	1 patient with renal cell carcinoma	N/A	8 Gy in 1 fraction	Sorafenib 400 mg twice daily for 5 weeks before and 3 days after RT	Grade 5 colon perforations, 1 week after SBRT	Yes
Lordick et al (31)	1 patient with renal cell carcinoma	N/A	28 Gy in 7 fractions	Bevacizumab 10 mg/kg every other week, 4 months after RT	Grade 5 cecal perforation, 3.5 months after SBRT	Yes
Stephans et al (32)	2 patients with lung/liver tumors near esophagus	29%	50 Gy in 5 fractions	Not specified; received anti-VEGF agent within 2 months of completing SBRT	≥Grade 3 esophageal fistula at median time of 8.4 months after SBRT	Yes
Barney et al (33)	1 patient with hepatocellular carcinoma	35%	30 Gy in 3 fractions	Sorafenib 400 mg BID, 1.3 months after SBRT	Grade 3 gastric ulcer, 4.6 months after SBRT	Yes
	1 patient with colorectal carcinoma		60 Gy in 5 fractions	Bevacizumab 5 mg/kg every 2 weeks, 0.5 months after SBRT	Grade 4 gastric perforation, 4.5 months after SBRT	Yes
	1 patient with pancreas cancer		42 Gy in 5 fractions	Bevacizumab 15 mg/kg every 3 weeks, 7 months after SBRT	Grade 5 duodenal perforation, 10.4 months after SBRT	Yes
	1 patient with melanoma		60 Gy in 3 fractions	Bevacizumab 15 mg/kg every 3 weeks, 2 months after SBRT	Grade 4 small bowel perforation, 5.1 months after SBRT	Yes
	1 patient with renal cell carcinoma		40 Gy in 5 fractions	Bevacizumab 10 mg/kg every 2 weeks, 16.3 months after SBRT	Grade 3 duodenal ulcer, 17.2 months after SBRT	Yes
	1 patient with melanoma		60 Gy in 3 fractions	Bevacizumab 10 mg/kg every 2 weeks, with SBRT	Grade 3 gastric ulcer, 3.1 months after SBRT	Yes
	1 patient with melanoma		60 Gy in 5 fractions	Bevacizumab 10 mg/kg every 2 weeks, 2.3 months after SBRT	Grade 4 gastric ulcer, 2.7 months after SBRT	Yes
Dawson et al (34)	1 patient with hepatocellular carcinoma	12.5%	33 Gy in 6 fractions	Sorafenib 400 mg daily, with SBRT	Grade 4 acute on chronic small bowel obstruction, 27 days after SBRT	Yes
	1 patient with hepatocellular carcinoma		30 Gy in 6 fractions	Sorafenib 400 mg daily, with SBRT	Grade 3 GI bleed, 51 days after SBRT	Yes

Abbreviations: GI = gastrointestinal; SBRT = stereotactic body radiation therapy; VEGF = vascular endothelial growth factor.