Estimation of a Self-Consistent Set of Radiobiological Parameters From Hypofractionated Versus Standard Radiation Therapy of Prostate Cancer

Pedicini, P.; Strigari, Lidia; Benassi, Marcello

doi:10.1016/j.ijrobp.2012.11.033

Cited by 42 publications

(55 citation statements)

References 27 publications

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“…Thus, in the process of treatment planning, dose constraints for given rectal volumes are recommended as a conservative starting point for 3D treatment planning [1]. However, the dose and its fractionation [20,21] are not the only actors in the determinism of toxicity risk. Several patient associated features have been shown to be potential predictive factors impacting on late GI toxicity in prostate cancer RT [8-10,15,22].…”

Section: Discussionmentioning

confidence: 99%

Multivariate normal tissue complication probability modeling of gastrointestinal toxicity after external beam radiotherapy for localized prostate cancer

et al. 2013

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BackgroundThe risk of radio-induced gastrointestinal (GI) complications is affected by several factors other than the dose to the rectum such as patient characteristics, hormonal or antihypertensive therapy, and acute rectal toxicity. Purpose of this work is to study clinical and dosimetric parameters impacting on late GI toxicity after prostate external beam radiotherapy (RT) and to establish multivariate normal tissue complication probability (NTCP) model for radiation-induced GI complications.MethodsA total of 57 men who had undergone definitive RT for prostate cancer were evaluated for GI events classified using the RTOG/EORTC scoring system. Their median age was 73 years (range 53–85). The patients were assessed for GI toxicity before, during, and periodically after RT completion. Several clinical variables along with rectum dose-volume parameters (Vx) were collected and their correlation to GI toxicity was analyzed by Spearman’s rank correlation coefficient (Rs). Multivariate logistic regression method using resampling techniques was applied to select model order and parameters for NTCP modeling. Model performance was evaluated through the area under the receiver operating characteristic curve (AUC).ResultsAt a median follow-up of 30 months, 37% (21/57) patients developed G1-2 acute GI events while 33% (19/57) were diagnosed with G1-2 late GI events. An NTCP model for late mild/moderate GI toxicity based on three variables including V65 (OR = 1.03), antihypertensive and/or anticoagulant (AH/AC) drugs (OR = 0.24), and acute GI toxicity (OR = 4.3) was selected as the most predictive model (Rs = 0.47, p < 0.001; AUC = 0.79). This three-variable model outperforms the logistic model based on V65 only (Rs = 0.28, p < 0.001; AUC = 0.69).ConclusionsWe propose a logistic NTCP model for late GI toxicity considering not only rectal irradiation dose but also clinical patient-specific factors. Accordingly, the risk of G1-2 late GI increases as V65 increases, it is higher for patients experiencing previous acute toxicity and it is lower for patients who take AH/AC drugs. The developed NTCP model could represent a potentially useful tool to be used in prospective trial and for comparison among different RT techniques.

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Section: Discussionmentioning

confidence: 99%

Multivariate normal tissue complication probability modeling of gastrointestinal toxicity after external beam radiotherapy for localized prostate cancer

et al. 2013

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“…Furthermore, the advantage of the ADC evaluation in prostate cancer could be the possibility of using such technique not only in diagnosis but also in therapy. In particular, these new DWI sequences could also be used as a way to derive some radiobiological parameters (27)(28)(29)(30).…”

Section: Resultsmentioning

confidence: 99%

Comparison Between Gleason Score and Apparent Diffusion Coefficient Obtained from Diffusion-Weighted Imaging of Prostate Cancer Patients

Caivano

Rabasco

Lotumolo

et al. 2013

Cancer Investigation

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“…In addition to its deviation from in vitro cell survival data, it often uses unreasonable radiobiological parameters when explaining patient treatment outcome. For example, fitting of clinical prostate treatment response to conventionally fractionated and hypofractionated treatment using LQ results in either unreasonably low a or fast repopulation time (47).…”

Section: Discussionmentioning

confidence: 99%

Incorporating Cancer Stem Cells in Radiation Therapy Treatment Response Modeling and the Implication in Glioblastoma Multiforme Treatment Resistance

Nguyen

Pajonk

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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Estimation of a Self-Consistent Set of Radiobiological Parameters From Hypofractionated Versus Standard Radiation Therapy of Prostate Cancer

Cited by 42 publications

References 27 publications

Multivariate normal tissue complication probability modeling of gastrointestinal toxicity after external beam radiotherapy for localized prostate cancer

Multivariate normal tissue complication probability modeling of gastrointestinal toxicity after external beam radiotherapy for localized prostate cancer

Comparison Between Gleason Score and Apparent Diffusion Coefficient Obtained from Diffusion-Weighted Imaging of Prostate Cancer Patients

Incorporating Cancer Stem Cells in Radiation Therapy Treatment Response Modeling and the Implication in Glioblastoma Multiforme Treatment Resistance

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