National Population-Based Study Comparing Treatment-Related Toxicity in Men Who Received Intensity Modulated Versus 3-Dimensional Conformal Radical Radiation Therapy for Prostate Cancer

Sujenthiran, Arunan; Nossiter, Julie; Charman, Susan C.; Parry, Matthew G.; Meulen, Jan van der; Cathcart, Paul; Clarke, Noel W.; Payne, Heather; Aggarwal, Ajay

doi:10.1016/j.ijrobp.2017.07.040

Cited by 42 publications

(35 citation statements)

References 32 publications

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“…More recently, a population-based study of 6933 prostate cancer patients treated with IMRT in the United Kingdom found that the incidence of gastrointestinal toxicities was low in the first nine months after radiation therapy; the highest rates were noted between nine months and approximately 2.5 years. 12 SpaceOAR use was not a consideration in these studies.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, the multicentre study of Schmid et al found the majority of late gastrointestinal side effects (≥grade 2) occurred within 9–60 months after three‐dimensional radiotherapy (70−74 Gy) with a peak at 24 months. More recently, a population‐based study of 6933 prostate cancer patients treated with IMRT in the United Kingdom found that the incidence of gastrointestinal toxicities was low in the first nine months after radiation therapy; the highest rates were noted between nine months and approximately 2.5 years . SpaceOAR use was not a consideration in these studies.…”

Section: Discussionmentioning

confidence: 99%

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Late toxicities of prostate cancer radiotherapy with and without hydrogel SpaceAOR insertion

et al. 2019

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Introduction To investigate whether the implantation of a hydrogel spacer (SpaceOAR) reduces long‐term rectal toxicity for prostate cancer patients treated with intensity‐modulated radiotherapy (IMRT). Methods Patients with localised prostate cancer treated with 81 Gy in 45 fx of IMRT over 9 weeks were retrospectively compared: 65 patients with SpaceOAR and 56 patients without SpaceOAR. Planning aims restricted rectal doses to V40 Gy < 35%, V65 Gy < 17%, V75 Gy < 10%. Toxicities were evaluated between 3 months and 3 years after the completion of radiotherapy and were based on the common terminology criteria for adverse events (CTCAE) assessment tool for diarrhoea, haemorrhoids, faecal incontinence and proctitis. Results The cumulative incidence of low‐grade diarrhoea (G1) was significantly higher in the non‐SpaceOAR group (21.4% vs 6.2%; P = 0.016). The cumulative incidence of proctitis (grades G1 and G2) was also higher in the non‐SpaceOAR group (26.7% vs 9.2%; P = 0.015); the cumulative incidence of G2 proctitis was higher in the latter group (P = 0.043). There were no differences between the treatment groups for cumulative incidences of faecal incontinence and/or haemorrhoids. Three years after IMRT, diarrhoea and proctitis were higher in the non‐SpaceOAR group, without reaching statistical significance. This finding was unchanged after correcting for baseline symptoms. Conclusion SpaceOAR is of benefit in reducing the cumulative incidence of low‐grade diarrhoea and proctitis for up to 3 years after intensity‐modulated radiotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Late toxicities of prostate cancer radiotherapy with and without hydrogel SpaceAOR insertion

et al. 2019

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“…year. Further evaluation after a longer follow-up period is required [18]. The limited number of patients also constitutes a weakness.…”

Section: Discussionmentioning

confidence: 99%

Early Toxicity of a Phase 2 Trial of Combined Salvage Radiation Therapy and Hormone Therapy in Oligometastatic Pelvic Node Relapses of Prostate Cancer (OLIGOPELVIS GETUG P07)

Vaugier

Palpacuer

Rio

et al. 2019

International Journal of Radiation Oncology*Biology*Physics

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“…Regarding toxicity between IMRT ( n = 6933) and 3D‐CRT ( n = 16 289), Sujenthrian et al . reported the results from a national population‐based study . The use of IMRT, as opposed to 3D‐CRT, increases from 3.1% in 2001 to 64.7% in 2013.…”

Section: Clinical Results Of Imrt For Prostate Cancermentioning

confidence: 99%

Current status of intensity‐modulated radiation therapy for prostate cancer: History, clinical results and future directions

Hatano¹,

Tohyama²,

Kodama³

et al. 2019

Int J of Urology

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External beam radiotherapy has changed dramatically over several decades with the improvement of computer hardware and software, and machinery developments. Intensity-modulated radiation therapy is the most sophisticated technique for all cancer treatment with radiation therapy, and is widely disseminated and available for daily use in many countries. Several retrospective and prospective studies have shown that intensity-modulated radiation therapy reduces the radiation dose in the organs at risk with diminished rates of acute and late toxicity, even with higher doses (>74 Gy). An important technique for the clinical use of intensity-modulated radiation therapy is image-guided radiation therapy. The clinical benefit for prostate image-guided radiation therapy has been assessed by comparing the outcomes of patients with either the image-guided radiation therapy or non-image-guided radiation therapy technique. These studies have shown that image-guided radiation therapy significantly decreases acute and late rectal and bladder toxicities. Randomized trials and meta-analysis have shown that higher doses result in better biochemical control. More recently, hypofractionated radiation therapy comparing hypofractionated radiation therapy versus conventional fractionated radiation therapy have shown that hypofractionated radiation therapy produces biochemical control and toxicity rated similar to those produced by conventional fractionated radiation therapy. The clinical use of ultrahypofractionated radiation therapy and simultaneous integrated boost technique is necessary to evaluate its further safety and benefits. Intensity-modulated radiation therapy is also widely accepted in the field of salvage therapy and for the patients with distant oligometastases. The purpose of the present review is to summarize the history of intensity-modulated radiation therapy, new techniques for intensity-modulated radiation therapy, hypofractionation and future directions for prostate cancer.

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National Population-Based Study Comparing Treatment-Related Toxicity in Men Who Received Intensity Modulated Versus 3-Dimensional Conformal Radical Radiation Therapy for Prostate Cancer

Cited by 42 publications

References 32 publications

Late toxicities of prostate cancer radiotherapy with and without hydrogel SpaceAOR insertion

Late toxicities of prostate cancer radiotherapy with and without hydrogel SpaceAOR insertion

Early Toxicity of a Phase 2 Trial of Combined Salvage Radiation Therapy and Hormone Therapy in Oligometastatic Pelvic Node Relapses of Prostate Cancer (OLIGOPELVIS GETUG P07)

Current status of intensity‐modulated radiation therapy for prostate cancer: History, clinical results and future directions

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