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Title: Localized volume effects for late rectal and anal toxicity after radiotherapy for prostate cancer

Abstract

Purpose: To identify dosimetric parameters derived from anorectal, rectal, and anal wall dose distributions that correlate with different late gastrointestinal (GI) complications after three-dimensional conformal radiotherapy for prostate cancer. Methods and Materials: In this analysis, 641 patients from a randomized trial (68 Gy vs. 78 Gy) were included. Toxicity was scored with adapted Radiation Therapy Oncology Group/European Organization for the Research and Treatment of Cancer (RTOG/EORTC) criteria and five specific complications. The variables derived from dose-volume histogram of anorectal, rectal, and anal wall were as follows: % receiving {>=}5-70 Gy (V5-V70), maximum dose (D{sub max}), and mean dose (D{sub mean}). The anus was defined as the most caudal 3 cm of the anorectum. Statistics were done with multivariate Cox regression models. Median follow-up was 44 months. Results: Anal dosimetric variables were associated with RTOG/EORTC Grade {>=}2 (V5-V40, D{sub mean}) and incontinence (V5-V70, D{sub mean}). Bleeding correlated most strongly with anorectal V55-V65, and stool frequency with anorectal V40 and D{sub mean}. Use of steroids was weakly related to anal variables. No volume effect was seen for RTOG/EORTC Grade {>=}3 and pain/cramps/tenesmus. Conclusion: Different volume effects were found for various late GI complications. Therefore, to evaluate the risk of late GI toxicity,more » not only intermediate and high doses to the anorectal wall volume should be taken into account, but also the dose to the anal wall.« less

Authors:
 [1];  [2];  [1];  [3];  [4];  [5];  [3]
  1. Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)
  2. Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands). E-mail: j.lebesque@nki.nl
  3. Department of Radiation Oncology, Erasmus Medical Centre, Rotterdam (Netherlands)
  4. Radiotherapeutic Institute Friesland, Leeuwarden (Netherlands)
  5. Zeeuws Radiotherapeutic Institute, Vlissingen (Netherlands)
Publication Date:
OSTI Identifier:
20793394
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 64; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2005.10.002; PII: S0360-3016(05)02736-7; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; PAIN; PROSTATE; RADIATION DOSE DISTRIBUTIONS; RADIATION DOSES; RADIOTHERAPY; STEROIDS; TOXICITY

Citation Formats

Peeters, Stephanie T.H., Lebesque, Joos V., Heemsbergen, Wilma D., Putten, Wim L.J. van, Slot, Annerie, Dielwart, Michel F.H., and Koper, Peter C.M. Localized volume effects for late rectal and anal toxicity after radiotherapy for prostate cancer. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.1.
Peeters, Stephanie T.H., Lebesque, Joos V., Heemsbergen, Wilma D., Putten, Wim L.J. van, Slot, Annerie, Dielwart, Michel F.H., & Koper, Peter C.M. Localized volume effects for late rectal and anal toxicity after radiotherapy for prostate cancer. United States. doi:10.1016/J.IJROBP.2005.1.
Peeters, Stephanie T.H., Lebesque, Joos V., Heemsbergen, Wilma D., Putten, Wim L.J. van, Slot, Annerie, Dielwart, Michel F.H., and Koper, Peter C.M. Wed . "Localized volume effects for late rectal and anal toxicity after radiotherapy for prostate cancer". United States. doi:10.1016/J.IJROBP.2005.1.
@article{osti_20793394,
title = {Localized volume effects for late rectal and anal toxicity after radiotherapy for prostate cancer},
author = {Peeters, Stephanie T.H. and Lebesque, Joos V. and Heemsbergen, Wilma D. and Putten, Wim L.J. van and Slot, Annerie and Dielwart, Michel F.H. and Koper, Peter C.M.},
abstractNote = {Purpose: To identify dosimetric parameters derived from anorectal, rectal, and anal wall dose distributions that correlate with different late gastrointestinal (GI) complications after three-dimensional conformal radiotherapy for prostate cancer. Methods and Materials: In this analysis, 641 patients from a randomized trial (68 Gy vs. 78 Gy) were included. Toxicity was scored with adapted Radiation Therapy Oncology Group/European Organization for the Research and Treatment of Cancer (RTOG/EORTC) criteria and five specific complications. The variables derived from dose-volume histogram of anorectal, rectal, and anal wall were as follows: % receiving {>=}5-70 Gy (V5-V70), maximum dose (D{sub max}), and mean dose (D{sub mean}). The anus was defined as the most caudal 3 cm of the anorectum. Statistics were done with multivariate Cox regression models. Median follow-up was 44 months. Results: Anal dosimetric variables were associated with RTOG/EORTC Grade {>=}2 (V5-V40, D{sub mean}) and incontinence (V5-V70, D{sub mean}). Bleeding correlated most strongly with anorectal V55-V65, and stool frequency with anorectal V40 and D{sub mean}. Use of steroids was weakly related to anal variables. No volume effect was seen for RTOG/EORTC Grade {>=}3 and pain/cramps/tenesmus. Conclusion: Different volume effects were found for various late GI complications. Therefore, to evaluate the risk of late GI toxicity, not only intermediate and high doses to the anorectal wall volume should be taken into account, but also the dose to the anal wall.},
doi = {10.1016/J.IJROBP.2005.1},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 4,
volume = 64,
place = {United States},
year = {Wed Mar 15 00:00:00 EST 2006},
month = {Wed Mar 15 00:00:00 EST 2006}
}