Intensity-modulated versus conventional pelvic radiotherapy for prostate cancer: Analysis of acute toxicity

Jani, Ashesh B.; Su, Andy; Milano, Michael T.

doi:10.1016/j.urology.2005.07.021

Cited by 33 publications

(25 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared with localized fields, however, pelvic irradiation carries the risk of increasing adverse effects rates, in particular for the intestine (5)(6)(7)(8). Although the typical shape of the lymph node target calls for use of IMRT (with the planning target volume very close to the intestine), relatively few institutions have yet reported on the application of IMRT for this subset of prostate cancer patients (9)(10)(11)(12)(13)(14). We have implemented IMRT for this patient group with the aim of reducing the normal tissue doses and toxicity, in particular those related to intestine irradiation.…”

Section: Introductionmentioning

confidence: 99%

Intensity-Modulated Radiotherapy of Pelvic Lymph Nodes in Locally Advanced Prostate Cancer: Planning Procedures and Early Experiences

Muren

Wasbø

Helle

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Purpose: We present planning and early clinical outcomes of a study of intensity-modulated radiotherapy (IMRT) for locally advanced prostate cancer. Methods and Materials: A total of 43 patients initially treated with an IMRT plan delivering 50 Gy to the prostate, seminal vesicles, and pelvic lymph nodes, followed by a conformal radiotherapy (CRT) plan delivering 20 Gy to the prostate and seminal vesicles, were studied. Dose-volume histogram (DVH) data for the added plans were compared with dose-volume histogram data for the sum of two CRT plans for 15 cases. Gastrointestinal (GI) and genitourinary (GU) toxicity, based on the Radiation Therapy Oncology Group scoring system, was recorded weekly throughout treatment as well as 3 to 18 months after treatment and are presented. Results: Treatment with IMRT both reduced normal tissue doses and increased the minimum target doses. Intestine volumes receiving more than 40 and 50 Gy were significantly reduced (e.g., at 50 Gy, from 81 to 19 cm 3 ; p = 0.026), as were bladder volumes above 40, 50, and 60 Gy, rectum volumes above 30, 50, and 60 Gy, and hip joint muscle volumes above 20, 30, and 40 Gy. During treatment, Grade 2 GI toxicity was reported by 12 of 43 patients (28%), and Grade 2 to 4 GU toxicity was also observed among 12 patients (28%). With 6 to 18 months of follow-up, 2 patients (5%) experienced Grade 2 GI effects and 7 patients (16%) experienced Grade 2 GU effects. Conclusions: Use of IMRT for pelvic irradiation in prostate cancer reduces normal tissue doses, improves target coverage, and has a promising toxicity profile. Ó

show abstract

Section: Introductionmentioning

confidence: 99%

Intensity-Modulated Radiotherapy of Pelvic Lymph Nodes in Locally Advanced Prostate Cancer: Planning Procedures and Early Experiences

Muren

Wasbø

Helle

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

show abstract

“…Several planning studies have demonstrated the superiority of IMRT compared with conformal RT (CRT) to shape the dose distribution to the planning target volume (PTV), thereby reducing the dose to the main organs-at-risk (OARs) (i.e., the bowel, rectum, and bladder) (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Also, a few clinical studies have indicated a better outcome with IMRT (4,6,13,14).…”

Section: Introductionmentioning

confidence: 99%

Influence of Organ Motion on Conformal vs. Intensity-Modulated Pelvic Radiotherapy for Prostate Cancer

Hysing

Skorpen

Alber³

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Purpose: To compare an intensity-modulated radiotherapy (IMRT) planning approach for prostate pelvic RT with a conformal RT (CRT) approach taking into account the influence of organ-at-risk (OAR) motion. Methods and Materials: A total of 20 male patients, each with one planning computed tomography scan and five to eight treatment computed tomography scans, were used for simulation of IMRT and CRT for delivery of a prescribed dose of 50 Gy to the prostate, seminal vesicles, and pelvic lymph nodes. Planning was done in Eclipse without correcting for OAR motion. Evaluation was performed using the CRT and IMRT dose matrices and the planning and treatment OAR outlines. The generalized equivalent uniform dose (gEUD) was calculated for 894 OAR volumes using a volume-effect parameter of 4, 12, and 8 for bowel, rectum and bladder, respectively. For the bowel, the gEUD was normalized to a reference volume of 200 cm 3 . For each patient and each OAR, an average of the treatment gEUDs (gEUD treat ) was calculated for CRT and IMRT. The paired t test was used to compare IMRT with CRT and gEUD treat with gEUD plan . Results: The mean gEUD treat was reduced from 43 to 40 Gy, 47 to 46 Gy, and 48 to 45 Gy with IMRT for the bowel, rectum, and bladder, respectively (p < 0.001). Differences between the gEUD plan and gEUD treat were not significant (p > 0.05) for any OAR but was >6% for the bowel in 6 of 20 patients. Conclusion: Intensity-modulated RT reduced the bowel, rectum, and bladder gEUDs also under influence of OAR motion. Neither CRT nor IMRT was robust against bowel motion, but IMRT was not less robust than CRT. Ó

show abstract

“…[3] As bowel, urinary, and sexual-related side effects are a concern with any prostate cancer treatment, enthusiasm for IMRT is largely based on the potential for translating this advance in targeting into better patient outcomes (i.e., improved cancer control and less toxicity). [4][5][6] While IMRT's targeting capabilities afford the possibility of improved outcomes, its unfettered dissemination is not without potential trade-offs. First, relative to the prior standard of 3-dimensional conformal therapy (3D-CRT), evidence supporting IMRT's advantages in terms of lower toxicity [4,5,7] and improved cancer control [6,8] is mixed.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6] While IMRT's targeting capabilities afford the possibility of improved outcomes, its unfettered dissemination is not without potential trade-offs. First, relative to the prior standard of 3-dimensional conformal therapy (3D-CRT), evidence supporting IMRT's advantages in terms of lower toxicity [4,5,7] and improved cancer control [6,8] is mixed. A comprehensive review noted that improvements in bowel toxicity were found in only half the studies comparing the two methods.…”

Section: Introductionmentioning

confidence: 99%

1818 Comparative Effectiveness of External Beam Radiation Approaches for Prostate Cancer

et al. 2012

View full text Add to dashboard Cite

show abstract

Intensity-modulated versus conventional pelvic radiotherapy for prostate cancer: Analysis of acute toxicity

Cited by 33 publications

References 26 publications

Intensity-Modulated Radiotherapy of Pelvic Lymph Nodes in Locally Advanced Prostate Cancer: Planning Procedures and Early Experiences

Intensity-Modulated Radiotherapy of Pelvic Lymph Nodes in Locally Advanced Prostate Cancer: Planning Procedures and Early Experiences

Influence of Organ Motion on Conformal vs. Intensity-Modulated Pelvic Radiotherapy for Prostate Cancer

1818 Comparative Effectiveness of External Beam Radiation Approaches for Prostate Cancer

Contact Info

Product

Resources

About