Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients
| Autor: | Uulke A. van der Heide, Wilma D. Heemsbergen, Joos V. Lebesque, Floris J. Pos, Marcel van Herk, Marnix G. Witte, Luca Incrocci, Ruud C. Wortel |
|---|---|
| Přispěvatelé: | Biomedical Engineering and Physics, Radiotherapy |
| Rok vydání: | 2015 |
| Předmět: |
Male
Organs at Risk Cancer Research medicine.medical_specialty medicine.medical_treatment Urinary system Urinary Bladder Urology Anal Canal Urogenital System law.invention Prostate cancer Randomized controlled trial SDG 3 - Good Health and Well-being law Prostate Humans Medicine Radiology Nuclear Medicine and imaging Aged Radiation business.industry Genitourinary system Rectum Prostatic Neoplasms Radiotherapy Dosage medicine.disease Acute toxicity Gastrointestinal Tract Radiation therapy medicine.anatomical_structure Oncology Toxicity Radiotherapy Intensity-Modulated Radiotherapy Conformal business Nuclear medicine Radiotherapy Image-Guided |
| Zdroj: | International journal of radiation oncology, biology, physics, 91(4), 737-744. Elsevier Inc. International Journal of Radiation Oncology Biology Physics, 91(4), 737-744. Elsevier Inc. |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2014.12.017 |
| Popis: | Purpose: Image-guided intensity modulated radiation therapy (IG-IMRT) allows significant dose reductions to organs at risk in prostate cancer patients. However, clinical data identifying the benefits of IG-IMRT in daily practice are scarce. The purpose of this study was to compare dose distributions to organs at risk and acute gastrointestinal (GI) and genitourinary (GU) toxicity levels of patients treated to 78 Gy with either IG-IMRT or 3D-CRT. Methods and Materials: Patients treated with 3D-CRT (n=215) and IG-IMRT (n=260) receiving 78 Gy in 39 fractions within 2 randomized trials were selected. Dose surface histograms of anorectum, anal canal, and bladder were calculated. Identical toxicity questionnaires were distributed at baseline, prior to fraction 20 and 30 and at 90 days after treatment. Radiation Therapy Oncology Group (RTOG) grade >= 1, >= 2, and >= 3 endpoints were derived directly from questionnaires. Univariate and multivariate binary logistic regression analyses were applied. Results: The median volumes receiving 5 to 75 Gy were significantly lower (all P= 2 toxicity was observed for proctitis, stool frequency >= 6/day, and urinary frequency >= 12/day. IG-IMRT resulted in significantly lower overall RTOG grade >= 2 GI toxicity (29% vs 49%, respectively, P=.002) and overall GU grade >= 2 toxicity (38% vs 48%, respectively, P=.009). Conclusions: A clinically meaningful reduction in dose to organs at risk and acute toxicity levels was observed in IG-IMRT patients, as a result of improved technique and tighter margins. Therefore reduced late toxicity levels can be expected as well; additional research is needed to quantify such reductions. (C) 2015 Elsevier Inc. All rights reserved. |
| Databáze: | OpenAIRE |
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