Five-year prospective patient evaluation of bladder and bowel symptoms after dose-escalated radiotherapy for prostate cancer with the BeamCath® technique

Fransson, Per; Bergström, Per; Löfroth, Per‐Olov; Widmark, Anders

doi:10.1016/j.ijrobp.2006.05.007

Cited by 17 publications

(11 citation statements)

References 34 publications

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“…These trials confirmed the fact that dose escalation increases late toxicities, especially for the rectum, when delivered without image guidance. A small number of studies have reported late toxicities for prostate cancer patients treated with dose-escalated radiation treatment combined with an image guidance technique such as FM-kV (25,(31)(32)(33). Our data support the fact that, for a selected radiation dose, PTV reduction margins with FM-kV should decrease the rate of late radiation toxicities, especially for the rectum but maybe not in the same magnitude as we initially thought.…”

Section: Ntcpsupporting

confidence: 76%

Dosimetric Impact and Theoretical Clinical Benefits of Fiducial Markers for Dose Escalated Prostate Cancer Radiation Treatment

Gauthier

Carrier

Béliveau-Nadeau

et al. 2009

International Journal of Radiation Oncology*Biology*Physics

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Section: Ntcpsupporting

confidence: 76%

Dosimetric Impact and Theoretical Clinical Benefits of Fiducial Markers for Dose Escalated Prostate Cancer Radiation Treatment

Gauthier

Carrier

Béliveau-Nadeau

et al. 2009

International Journal of Radiation Oncology*Biology*Physics

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“…Fransson et al (12) reported a prospective analysis of bowel symptoms before and 1, 3, and 5 years after CRT for prostate cancer. A total of 363 patients were included in the study, but 79 did not respond to the baseline questionnaire.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Study of Intestinal Symptoms and Fecal Continence in Patients With Conformal Radiotherapy for Prostate Cancer

Geinitz

Thamm

Keller

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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“…During the past two decades, 7 randomized trials and one meta-analysis have shown improvements of 10 to 20% in biological progression-free survival rates (bPFS) and freedom from metastatic disease (in D’Amico high risk patients) by using dose-escalated radiotherapy [1–8]. However, increasing the dose carries a potential risk of severe rectal and urinary side effects [9–12], especially when former conventional radiation techniques like three-dimensional conformal radiotherapy (3D-CRT) are used.…”

Section: Introductionmentioning

confidence: 99%

Intensity-modulated radiation therapy from 70Gy to 80Gy in prostate cancer: six- year outcomes and predictors of late toxicity

et al. 2017

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ObjectiveTo report grade ≥2 overall late rectal and urinary toxicities in patients (pts) with prostate cancer treated by intensity-modulated radiotherapy (IMRT) at 3 dose-levels. Identify predictors of radiation toxicity and report biochemical progression free survival (bPFS).MethodsA total of 277 pts were treated with 70Gy (10.8%), 74Gy (63.9%) and 80 Gy (25.3%) using IMRT without pelvic irradiation were analyzed. Short or long-course androgen deprivation therapy (ADT) was allowed in 46.1% of pts. The toxicity was described using the Common Terminology Criteria for Adverse Events (CTCAE) v4.0 scale. Cox regression models addressed demographics, disease and dosimetry characteristics as potential predictors of late grade ≥2 toxicity after adjusting for other modifying factors.ResultsThe median follow-up was 77 months (range 15; 150). There was no grade ≥4 toxicity. The 5-year cumulative rate of grade ≥2 late rectal and urinary toxicities was 6.3% (95% CI = 3.8%; 10.3%) and 25.3% (95% CI = 19.8%; 31.8%) respectively. In multivariate analysis, only the dose (80Gy vs 74 and 70Gy) was found to increase the risk of rectal toxicity (HR = 2.96 [1.07; 8.20]). For pts receiving 74 Gy, International Prostate Symptom Score (IPSS) at baseline ≥8 (HR = 2.40 [1.08; 5.35]) and dose ≥73Gy delivered in more than 2% of bladder (D2%) were found to be predictors of bladder toxicity (HR = 3.29 [1.36; 7.98]). The 5–year biochemical relapse free survival was 81.0% [74.5%; 86.0%] in the entire population, 97.5% [83.5%; 99.6%] in the low risk group, 84.9% [76.7%; 90.3%] in the intermediate risk group and 66.4% [51.8%; 77.4%] in the high-risk group. D’Amico low (HR = 0.09 [0.01; 0.69]) and intermediate risk groups (HR = 0.50 [0.28; 0.88]) as well as PSA nadir ≥0.2 ng/ml (HR = 1.79 [1.01; 3.21]) were predictive of biochemical relapse.ConclusionsThe rate of late rectal toxicity increased with higher doses, while Dmax ≥74Gy, D2% ≥ 73Gy for bladder wall and baseline IPSS ≥8 increased late urinary toxicity.

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Five-year prospective patient evaluation of bladder and bowel symptoms after dose-escalated radiotherapy for prostate cancer with the BeamCath® technique

Cited by 17 publications

References 34 publications

Dosimetric Impact and Theoretical Clinical Benefits of Fiducial Markers for Dose Escalated Prostate Cancer Radiation Treatment

Dosimetric Impact and Theoretical Clinical Benefits of Fiducial Markers for Dose Escalated Prostate Cancer Radiation Treatment

Longitudinal Study of Intestinal Symptoms and Fecal Continence in Patients With Conformal Radiotherapy for Prostate Cancer

Intensity-modulated radiation therapy from 70Gy to 80Gy in prostate cancer: six- year outcomes and predictors of late toxicity

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