Incidence of Late Rectal and Urinary Toxicities After Three-Dimensional Conformal Radiotherapy and Intensity-Modulated Radiotherapy for Localized Prostate Cancer

Journal Article · Sat Mar 15 04:00:00 EDT 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.11.044· OSTI ID:21039834

Levin, Emily J ^[1]; Hunt, Margie ^[2]; Yamada, Yoshiya; Shippy, Alison M ^[1]; Jackson, Andrew; Amols, Howard I ^[2]

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1. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
2. Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

Purpose: To report the incidence and predictors of treatment-related toxicity at 10 years after three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) for localized prostate cancer. Methods and Materials: Between 1988 and 2000, 1571 patients with stages T1-T3 prostate cancer were treated with 3D-CRT/IMRT with doses ranging from 66 to 81 Gy. The median follow-up was 10 years. Posttreatment toxicities were all graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events. Results: The actuarial likelihood at 10 years for the development of Grade {>=}2 GI toxicities was 9%. The use of IMRT significantly reduced the risk of gastrointestinal (GI) toxicities compared with patients treated with conventional 3D-CRT (13% to 5%; p < 0.001). Among patients who experienced acute symptoms the 10-year incidence of late toxicity was 42%, compared with 9% for those who did not experience acute symptoms (p < 0.0001). The 10-year incidence of late Grade {>=}2 genitourinary (GU) toxicity was 15%. Patients treated with 81 Gy (IMRT) had a 20% incidence of GU symptoms at 10 years, compared with a 12% for patient treated to lower doses (p = 0.01). Among patients who had developed acute symptoms during treatment, the incidence of late toxicity at 10 years was 35%, compared with 12% (p < 0.001). The incidence of Grade 3 GI and GU toxicities was 1% and 3%, respectively. Conclusions: Serious late toxicity was unusual despite the delivery of high radiation dose levels in these patients. Higher doses were associated with increased GI and GU Grade 2 toxicities, but the risk of proctitis was significantly reduced with IMRT. Acute symptoms were a precursor of late toxicities in these patients.

• OSTI ID: 21039834
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 70; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
HEALTH HAZARDS
PATIENTS
PROCTITIS
PROSTATE
RADIATION DOSES
RADIOTHERAPY
RECTUM
SYMPTOMS
TOXICITY