Clinical and Dosimetric Predictors of Acute Toxicity After a 4-Week Hypofractionated External Beam Radiotherapy Regimen for Prostate Cancer: Results From a Multicentric Prospective Trial
- Departments of Radiotherapy, Regina Elena National Cancer Institute, Rome (Italy)
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome (Italy)
- Department of Radiotherapy Oncology Center, Universitair Ziekenhuis Brussels, Jette (Belgium)
- Department of Radiotherapy, Ghent University Hospital, Ghent (Belgium)
Purpose: To investigate predictors for gastrointestinal (GI) and genitourinary (GU) acute toxicity after a short-course hypofractionated radiotherapy regimen for prostate cancer. Materials and Methods: Three institutions included 102 patients with T1-T3N0M0 prostate cancer in a Phase II study. Patients were treated with 56 Gy in 16 fractions over 4 weeks. Acute toxicity was scored weekly during treatment and 1 and 2 months after treatment using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria extended with additional symptoms and the International Prostate Symptom Index (IPSS). Correlation with a number of clinical and dosimetric parameters was assessed by univariate and multivariate analyses. Results: No Grade 3 or 4 GI side effects were observed. Grades 1 and 2 rectal GI toxicity occurred in 36%, and 38%, respectively. Corresponding figures for Grades 1 and 2 GU toxicity were 42% and 39%, respectively. Grade 3 or higher GU toxicity was detected in 4% of patients. In multivariate analysis, percent rectal volumes higher than 8% receiving doses {>=}53 Gy (V{sub 53}) were statistically correlated to Grade 2 acute rectal reaction (p = 0.006). For GU morbidity, only the IPSS pretreatment score was independently associated (p = 0.0036) with an increase in GU acute effects. Conclusions: Acute GU and GI toxicity were comparable with other series. Our data show that increased incidence and intensity of acute toxicity is a transient effect related to shorter overall treatment time rather than a larger effect in biological equivalent dose with respect to a conventional fractionation regime.
- OSTI ID:
- 21172531
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 73, Issue 1; Other Information: DOI: 10.1016/j.ijrobp.2008.04.005; PII: S0360-3016(08)00642-1; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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