3D - Conformal Radiotherapy (3DCRT) for decades was a standard technique in the prostate cancer radical radiotherapy treatment. Technological advances and implementation of an innovative radiotherapy technique - Intensity Modulated Radiation Therapy (IMRT), enable even more precise treatment of the prostate cancer patients. Intensity Modulated Radiation Therapy (IMRT) is a technological advancement in Conformal Radiotherapy which allows superior conformity and homogeneity of the absorbed dose in planning target volume with maximal sparing organs of risk. This technique gives us possibility to escalate the radiotherapy dose, prerequisite for the adequate local tumor control. Evaluation of dosimetric parameters 3DCRT vs. IMRT: the homogeneity index, the conformity index, parameters of absorbed dose in planning target volume, dose volume constraints for organs of risk shows that IMRT is an optimal technique in the prostate cancer radical treatment.

ApstraktImplementacijom IMRT tehnike moguće je eskalirati radioterapijsku dozu bez povećane incidence akutnih i hroničnih neželjenih efekata. Cilj ove studije je kompariranje akutnih i hroničnih genitourinarnih i gastrointestinalnih neželjenih efekata, kod pacijenata planiranih 3D CRT i IMRT tehnikom. Ova studija je uključila 35 pacijenata u studijskoj grupi A planiranih IMRT tehnikom, i 35 pacijenata u studijskoj grupi B planiranih 3D CRT tehnikom. Pacijenti su selektirani i upućeni na radikalni zračni tretman karcinoma prostate. Akutni genitourinarni i gastrointestinalni toksicitet je evaluiran tokom radioterapijskog tretmana, prema preporukama RTOG grupe. Kasni gastrointestinalni i genitourinarni neželjeni efekti su evaluirani tokom redovnih kontrolnih pregleda 6 mjeseci nakon završenog zračnog tretmana. Bazirano na rezultatima χ2 testa nije bilo statistički signifikantne razlike (p>0,05) izmedju studijskih grupa A i B kada su u pitanju akutni gastrointestinalni i genitourinarni efekti, uprkos eskaliranoj radioterapijskoj dozi u studijskoj grupi B planiranoj IMRT tehnikom. Prema rezultatima χ2 testa nije bilostatistički signifikantne razlike (p>0, 05) izmedju studijske grupeA i B kada su u pitanju hronični gastrointestinalni i genitourinarni neželjeni efekti. Intenzitetom modulisana zračna terapija je optimalna radioterapijska tehnika u radikalnom tretmanu karcinoma prostate. Ova tehnika omogućava klinički benefit u poređenju sa 3D konformalnom radioterapijomeskalaciju radioterapijske doze bez povećanog toksiciteta kod pacijenata planiranih IMRT tehnikom.Ključne reči: 3D konformalna radioterapija, Intenzitetom modulisana zračna terapija, neželjeni efekti Abstract Implementation of IMRT offers possibility to escalate radiation therapy dose without increased acute and late toxicity. The aim of this study is to compare acute and late genitourinary and gastrointestinal toxicity in patients treated with IMRT and 3DCRT technique. This study included 35 patients in study group A treated with IMRT technique, and 35 patients in study group B treated with 3DCRT technique. Patients were selected and referred to radical radiotherapy treatment prostate cancer. Acute genitourinary and gastrointestinal toxicity was evaluated during radiotherapy treatment according to recommendation of RTOG group. Late gastrointestinal and genitourinary toxicity was evaluated during regular control exams after radical radiotherapy treatment for six months. Based on the results χ2 test there was no statistical significant difference (p>0,05) between study group A i B in terms of acute gastrointestinal and genitourinary despite escalated radiotherapy dose in study group B treated with IMRT technique. Based on the results χ2 test there was no statistical significant difference (p>0, 05) between study group A i B in terms of late gastrointestinal and genitourinary toxicity. Intensity modulated radiation therapy is optimal technique in the radical treatment prostate cancer. This technique allows clinical benefit compared with 3D conformal radiothe...

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