Comparison of genitourinary and gastrointestinal toxicity among four radiotherapy modalities for prostate cancer: Conventional radiotherapy, intensity-modulated radiotherapy, and permanent iodine-125 implantation with or without external beam radiotherapy

Sutani, Shinya; Ohashi, Toshio; Sakayori, Motoko; Kaneda, Tomoya; Yamanaka, Shōji; Momma, Tetsuo; Hanada, Takashi; Shiraishi, Yasuyuki; Fukada, Junichi; Oya, Mototsugu; Shigematsu, Naoyuki

doi:10.1016/j.radonc.2015.08.019

Cited by 22 publications

(24 citation statements)

References 38 publications

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“…[4,28,42,43,46]). Additionally, some of the studies have correlated the mid and low-mid dose regions with late rectal bleeding [28,30,32,33] and stool frequency/urgency/tenesmus [26,30,32,37] respectively.…”

Section: Discussionmentioning

confidence: 99%

Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications

et al. 2016

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Background: Derivation of dose-volume correlated with toxicity for multi-modal treatments can be difficult due to the perceived need for voxel-by-voxel dose accumulation. With data available for a single-institution cohort with long follow-up, an investigation was undertaken into rectal dose-volume effects for gastrointestinal toxicities after deformably-registering each phase of a combined external beam radiotherapy (EBRT)/high-dose-rate (HDR) brachytherapy prostate treatment.

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Section: Discussionmentioning

confidence: 99%

Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications

et al. 2016

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“…Different total dose of radiation varies according to cancer severity and higher doses likely increase the odds of toxicity in the genitourinary system. The urinary bladder is particularly sensitive to low radiation doses and is often more affected than other pelvic tissues [1], especially due to low urothelium cell turnover [2]. …”

Section: Introductionmentioning

confidence: 99%

“…RHC may occur 3 months to even 14 years after radiotherapy and men are more predisposed than women (2.8 : 1), as prostate cancer is often treated with radiotherapy sessions [1, 4]. RHC is characterized by progressive fibrotic obliteration of mucosal arterioles and capillaries, leading to tissue hypoxia and necrosis [3].…”

Section: Introductionmentioning

confidence: 99%

“…RHC is characterized by progressive fibrotic obliteration of mucosal arterioles and capillaries, leading to tissue hypoxia and necrosis [3]. Cystoscopy depicts neovascularization and telangiectasia, which can result in severe and refractory macroscopic hematuria [1]. Gross and prolonged hematuria may require successive blood transfusions, several hospital admissions, and surgical treatments to the patient, increasing hospital costs and mortality rates [5, 6].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Severe Refractory Hematuria due to Radiation-Induced Hemorrhagic Cystitis with Dexamethasone

Nascimento

Campelo

Aragão

et al. 2017

Case Reports in Medicine

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Treatment of pelvic neoplasms with radiotherapy may develop sequelae, especially RHC. An 85-year-old male patient was admitted to a hospital emergency with gross hematuria leading to urinary retention and was diagnosed with RHC. The urinary bladder was probed, unobstructed, and maintained in continuous three-way saline irrigation. During 45 days of hospitalization, the patient underwent two cystoscopic procedures for urinary bladder flocculation, whole blood transfusions, and one platelet apheresis. None of these interventions led to clinical resolution. As the patient hematological condition was deteriorating, dexamethasone (4 mg i.v., bolus of 6/6, 12/12, and 24 h during five days) and epoetin alpha (1000 IU, 1 ml, s.c., for four weeks) were administered which led to the remission of the urinary bleeding. Dexamethasone therapy may be considered for RHC, when conventional treatments are not effective or are not possible, avoiding more aggressive interventions such as cystectomy.

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“…There are many publications which demonstrate the benefits of IMRT in radiotherapy for patients with prostate cancer [1][2][3][4][5][6][7][8][9]. However, only a few of them have evaluated the feasibility of this technique for patients after prostatectomy [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Comparison of 3D-CRT and IMRT techniques in radiotherapy for post-prostatectomy patients with a higher risk of nodal involvement

Poncyljusz

Kukołowicz

Chorąży

et al. 2017

Nowotwory. Journal of Oncology

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Background. Irradiation of a larger volume of the target may lead to an increase of the doses delivered to the surrounding organs at risk (OAR) for post-prostatectomy patients with a higher risk of nodal involvement. It was anticipated that IMRT significantly improved OAR sparing. The aim of this study was to provide a dosimetric comparison between conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) treatment plans for patients with prostate cancer irradiated to the prostate bed and pelvic lymph-nodal area. Materials and methods. The 3D-CRT and IMRT plans were created for ten patients after prostatectomy. The treatment plans were generated for the prostate bed (PTV1) and the pelvic lymph nodes (PTV2). The sum of PTV1 and PTV2 was irradiated to a mean dose of 46 Gy in 23 fractions, and additionally PTV1 was irradiated to a mean dose of 18 Gy in 9 fractions. Target coverage and the doses delivered to the pelvic bones, the rectum, the bladder, the bowel bag, and the femurs, were compared between techniques. The Wilcoxon signed-rank test was used to compare the dosimetric parameters. Results. The dosimetric quality of 3D-CRT and IMRT plans were comparable for target coverage (the mean value of PTV1 V95%, the mean value of PTV2 V95% all > 99%). The IMRT plans resulted in significant reductions in the pelvic bones Conclusions. The analysis presented in this paper demonstrates that the IMRT technique reduces the delivered dose to the OARs. Most interesting was the possibility of reducing the delivered dose to the pelvic bones and the bowel bag. This allowed us to expect a decreased risk of acute hematologic toxicity and acute gastrointestinal toxicity. NOWOTWORY J Oncol 2016; 66, 6: 440-444

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Comparison of genitourinary and gastrointestinal toxicity among four radiotherapy modalities for prostate cancer: Conventional radiotherapy, intensity-modulated radiotherapy, and permanent iodine-125 implantation with or without external beam radiotherapy

Cited by 22 publications

References 38 publications

Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications

Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications

Treatment of Severe Refractory Hematuria due to Radiation-Induced Hemorrhagic Cystitis with Dexamethasone

Comparison of 3D-CRT and IMRT techniques in radiotherapy for post-prostatectomy patients with a higher risk of nodal involvement

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