AIM: To evaluate toxicity of high conformal image-guided radiotherapy of the prostate bed. BACKGROUND: Radiotherapy of the prostate bed has a pivotal role in the post-operative and salvage settings, but few clinical data are available on the use of daily image guidance in combination with highly conformal techniques, and data on long-term results are lacking. MATERIALS AND METHODS: We analyzed 118 patients irradiated on the prostate bed using conformal plans processed with a micro-multileaf collimator, and daily checking treatment set-up with a cone-beam CT system. Correlation between toxicity and clinical-dosimetric parameters was assessed by the Cox regression model and log-rank test. Survival analyses were performed with the Kaplan-Meier method. RESULTS: Median follow-up was 54.08 months. Late grade ≥2 gastro-intestinal (GI) and genito-urinary (GU) toxicity were 3.4% and 4.2%, respectively. Actuarial 4-year late grade ≥2 GI and GU toxicities were 4% and 6%, respectively. Four-year relapse-free survival was 87%. At log-rank test, acute grade ≥2 GI toxicity is associated with the use of antihypertensives (p = 0.03), and there is a trend toward significance between the use of anticoagulants and late grade ≥2 GI toxicity (p = 0.07). At Cox analysis, acute grade ≥2 GU toxicity is correlated with the percentage of bladder volume receiving more than 65 Gy (p = 0.02, HR 1.87 CI 1.25-2.8), and the maximal dose to the rectum is correlated to the development of late grade ≥2 GI toxicity (p = 0.03, HR 2.75 CI 1.10-6.9). CONCLUSIONS: Conformal volumetric image-guided radiotherapy of the prostate bed leads to low toxicity rates.
AIM: To evaluate toxicity of high conformal image-guided radiotherapy of the prostate bed. BACKGROUND: Radiotherapy of the prostate bed has a pivotal role in the post-operative and salvage settings, but few clinical data are available on the use of daily image guidance in combination with highly conformal techniques, and data on long-term results are lacking. MATERIALS AND METHODS: We analyzed 118 patients irradiated on the prostate bed using conformal plans processed with a micro-multileaf collimator, and daily checking treatment set-up with a cone-beam CT system. Correlation between toxicity and clinical-dosimetric parameters was assessed by the Cox regression model and log-rank test. Survival analyses were performed with the Kaplan-Meier method. RESULTS: Median follow-up was 54.08 months. Late grade ≥2 gastro-intestinal (GI) and genito-urinary (GU) toxicity were 3.4% and 4.2%, respectively. Actuarial 4-year late grade ≥2 GI and GU toxicities were 4% and 6%, respectively. Four-year relapse-free survival was 87%. At log-rank test, acute grade ≥2 GI toxicity is associated with the use of antihypertensives (p = 0.03), and there is a trend toward significance between the use of anticoagulants and late grade ≥2 GI toxicity (p = 0.07). At Cox analysis, acute grade ≥2 GU toxicity is correlated with the percentage of bladder volume receiving more than 65 Gy (p = 0.02, HR 1.87 CI 1.25-2.8), and the maximal dose to the rectum is correlated to the development of late grade ≥2 GI toxicity (p = 0.03, HR 2.75 CI 1.10-6.9). CONCLUSIONS: Conformal volumetric image-guided radiotherapy of the prostate bed leads to low toxicity rates.
Authors: Jana Sefrova; Karel Odrazka; Petr Paluska; Zdenek Belobradek; Milos Brodak; Martin Dolezel; Petr Prosvic; Zuzana Macingova; Milan Vosmik; Petr Hoffmann; Miroslav Louda; Anna Nejedla Journal: Int J Radiat Oncol Biol Phys Date: 2011-03-21 Impact factor: 7.038
Authors: Shawn Malone; Jennifer Croke; Nicolas Roustan-Delatour; Eric Belanger; Leonard Avruch; Colin Malone; Christopher Morash; Cathleen Kayser; Kathryn Underhill; Yan Li; Kyle Malone; Balazs Nyiri; Johanna Spaans Journal: Int J Radiat Oncol Biol Phys Date: 2012-03-22 Impact factor: 7.038
Authors: Sameer K Nath; Ajay P Sandhu; Brent S Rose; Daniel R Simpson; Polly D Nobiensky; Jia-Zhu Wang; Fred Millard; Christopher J Kane; J Kellogg Parsons; Arno J Mundt Journal: Int J Radiat Oncol Biol Phys Date: 2009-11-24 Impact factor: 7.038
Authors: Gordon W Wong; Kerrin L Palazzi-Churas; David F Jarrard; David R Paolone; Andrew K Graf; Sean P Hedican; John D Wegenke; Mark A Ritter Journal: Int J Radiat Oncol Biol Phys Date: 2007-09-14 Impact factor: 7.038