Obesity and Hypofractionated Prostate Radiotherapy: Evaluation of Body Mass Index Influence on Dose-Volume Plan Characteristics

Bishop, Maryann; Miller, Steven; Joiner, Michael C.; Sauve, K.; Burmeister, Jay; Paximadis, Peter

doi:10.1016/j.ijrobp.2017.06.2143

Cited by 2 publications

(2 citation statements)

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“…This finding is similar to other retrospective reports in the brachytherapy and hypofractionation settings, and has been postulated to be associated with differential patterns of abdominopelvic fat distribution in obese patients. [18][19][20] Although larger body habitus may prompt use of higher photon beam energy levels, in our study cohort we did not find BMI to be a statistically significant predictor of beam energy levels, nor was there a statistically significant association between beam energy level and rectal V65.…”

Section: Discussioncontrasting

confidence: 74%

Radiation Dose to the Rectum With Definitive Radiation Therapy and Hydrogel Spacer Versus Postprostatectomy Radiation Therapy

Yang

Verma

et al. 2020

Advances in Radiation Oncology

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Purpose Management options for localized prostate cancer include definitive radiation therapy (RT) or radical prostatectomy, with a subset of surgical patients requiring adjuvant or salvage RT after prostatectomy. The use of a peri-rectal hydrogel spacer in patients receiving definitive RT has been shown to reduce rectal doses and toxicity. However, in the postprostatectomy setting, a hydrogel spacer cannot be routinely placed. Therefore, we sought to compare rectal dosimetry between definitive RT with a hydrogel spacer versus postoperative RT. Methods and Materials We identified patients with prostate cancer who underwent conventionally fractionated RT. Rectal dosimetry was evaluated between 2 groups: definitive RT with a hydrogel spacer (79.2 Gy, group 1) and postoperative RT (70.2 Gy, group 2). Rectal dosimetry values were tabulated and compared using Mann-Whitney U test. We implemented a Bonferroni correction to account for multiple comparisons (threshold P < .005). Linear regression analysis evaluated predictors of candidate rectal dose-volume parameters. Results We identified 51 patients treated during years 2017 to 2018; 16 (31%) and 35 (69%) patients were included in groups 1 and 2, respectively. The rectal volume receiving ≥65 Gy (V65) was significantly lower in group 1 (median, 2.1%; interquartile range, 0.9%-3.1%) than in group 2 (10.7%, 6.6%-14.5%) ( P < .001). Use of a hydrogel spacer in the definitive setting was independently associated with lower V65 ( P < .001). Similar results were found for V60, V55, V50, and V45 ( P < .005 for all). Conclusions Rectal dosimetry is more favorable for definitive RT (79.2 Gy) with a hydrogel spacer compared with postoperative RT (70.2 or 66.6 Gy). This may inform shared decision-making regarding primary management of prostate cancer, especially among patients at high risk of needing postoperative RT after prostatectomy.

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Section: Discussioncontrasting

confidence: 74%

Radiation Dose to the Rectum With Definitive Radiation Therapy and Hydrogel Spacer Versus Postprostatectomy Radiation Therapy

Yang

Verma

et al. 2020

Advances in Radiation Oncology

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“…In addition, several studies focused on the impact of patient size on other aspects of radiotherapy, namely patient setup accuracy [16,20,21] and radiation dosimetry [22][23][24], which may have an effect on radiation toxicities. Thereby, the relationship between patient size and toxicities is multifaceted.…”

Section: Introductionmentioning

confidence: 99%

Effect of patient thickness on acute gastrointestinal toxicities following radiotherapy for prostate cancer

Pisani

Bezzina

Couto

2021

Rep Pract Oncol Radiother.

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Obesity and Hypofractionated Prostate Radiotherapy: Evaluation of Body Mass Index Influence on Dose-Volume Plan Characteristics

Cited by 2 publications

References 0 publications

Radiation Dose to the Rectum With Definitive Radiation Therapy and Hydrogel Spacer Versus Postprostatectomy Radiation Therapy

Radiation Dose to the Rectum With Definitive Radiation Therapy and Hydrogel Spacer Versus Postprostatectomy Radiation Therapy

Effect of patient thickness on acute gastrointestinal toxicities following radiotherapy for prostate cancer

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