Predictors for Rectal and Intestinal Acute Toxicities During Prostate Cancer High-Dose 3D-CRT: Results of a Prospective Multicenter Study

Vavassori, V.; Fiorino, Claudio; Rancati, T.; Magli, A.; Fellin, Gianni; Baccolini, Michela; Bianchí, C.; Cagna, E.; Mauro, F.; Monti, A.F.; Muñoz, Fernándo; Stasi, M.; Franzone, P.; Valdagni, Riccardo

doi:10.1016/j.ijrobp.2006.10.040

Cited by 92 publications

(60 citation statements)

References 42 publications

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“…The reduction of the fraction of rectum receiving intermediate-low doses may be one of the causes of the very mild acute GI toxicity profiles experienced by both TOMOADV [3] and TOMOSIB [17] patients, as suggested by recent investigations about dose-volume relationships for acute rectal toxicity (see for instance [18]), suggesting a parallel behaviour for this endpoint.…”

Section: Discussionmentioning

confidence: 92%

Physics aspects of prostate tomotherapy: Planning optimization and image-guidance issues

et al. 2008

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Section: Discussionmentioning

confidence: 92%

Physics aspects of prostate tomotherapy: Planning optimization and image-guidance issues

et al. 2008

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“…Also, it could offer the possibility of dose escalation and probably increase local control and survival. Treatment planning comparison studies have shown the potential benefit of HT to deliver more precise RT [28]. HT probably helps to reduce treatment toxicity, but this hypothesis has not yet been demonstrated in a randomized setting.…”

Section: Discussionmentioning

confidence: 99%

“…HT probably helps to reduce treatment toxicity, but this hypothesis has not yet been demonstrated in a randomized setting. The literature shows rates of acute GU and GI toxicity grade 2 or greater of 6-24 and 3-12%, respectively [28,29]. When a planning comparison of HT and intensity-modulated RT was performed, HT showed a reduction in the fraction of intestinal cavity receiving intermediate-low doses such as V 20 and V 40 [28].…”

Section: Discussionmentioning

confidence: 99%

Image-Guided Radiation Therapy Based on Helical Tomotherapy in Prostate Cancer: Minimizing Toxicity

Acevedo-Henao

Guerra²,

Matute³

et al. 2014

Oncol Res Treat

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Background: We report the clinical results and prognostic factors of image-guided radiation therapy (RT) with helical tomotherapy (HT) for localized and recurrent prostate cancer (PC). Patients and Methods: We evaluated 70 patients with PC (primary diagnosis, n = 48; adjuvant, n = 5; salvage, n = 17) treated with HT from May 2006 through January 2011. The dose prescribed to the prostate/surgical bed ranged between 60 and 78 Gy. Potential risk factors for genitourinary (GU) and gastrointestinal (GI) toxicity were assessed. Results: The median age was 68 years (range 51-87 years). The median follow-up was 37 months (range 3-74 months). The rates of acute grade 2 GI and GU toxicities were 10 and 13%, respectively. Only 1 patient experienced acute grade 3 GU toxicity. The rates of late grade ≥ 2 GI and GU toxicities were 1% each. Multivariate analysis showed an association between rectum mean dose > median (39 Gy) and bladder median dose > median (46 Gy) with a higher grade of acute GI (p = 0.017) and GU (p = 0.019) toxicity, respectively. Additionally, older age was associated with late GU toxicity (p = 0.026). Conclusion: Toxicity with HT is low and is associated with higher median/mean doses in organs at risk as well as with older age. A prospective validation would be necessary to confirm these results.

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“…[1][2][3][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Distinctive anatomical features characterized the first nine definitions of the rectum as an OAR, whereas the last four were functional definitions, in which the rectum was exclusively considered with regard to the PTV. All the contouring throughout the entire study was performed by one experienced consultant (RMH) to exclude interobserver variability.…”

Section: Methodsmentioning

confidence: 99%

Comparison of different contouring definitions of the rectum as organ at risk (OAR) and dose–volume parameters predicting rectal inflammation in radiotherapy of prostate cancer: which definition to use?

Nitsche

Brannath

Brückner

et al. 2017

The British Journal of Radiology

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MN and RMH contributed to the conception, design, analysis and interpretation of data and helped with the final approval of the version to be published. MN, RMH and NT helped with the drafting of the article. WB and MB contributed to the statistics of the main study. DW contributed to the acquisition of data. AK contributed to the statistics of pre-study. NT helped with the planning and implementation of radiotherapy.Objective: The objective of this retrospective planning study was to find a contouring definition for the rectum as an organ at risk (OAR) in curative three-dimensional external beam radiotherapy (EBRT) for prostate cancer (PCa) with a predictive correlation between the dosevolume histogram (DVH) and rectal toxicity. Methods: In a pre-study, the planning CT scans of 23 patients with PCa receiving definitive EBRT were analyzed. The rectum was contoured according to 13 different definitions, and the dose distribution was correlated with the respective rectal volumes by generating DVH curves. Three definitions were identified to represent the most distinct differences in the shapes of the DVH curves: one anatomical definition recommended by the Radiation Therapy Oncology Group (RTOG) and two functional definitions based on the target volume. In the main study, the correlation between different relative DVH parameters derived from these three contouring definitions and the occurrence of rectal toxicity during and after EBRT was studied in two consecutive collectives. The first cohort consisted of 97 patients receiving primary curative EBRT and the second cohort consisted of 66 patients treated for biochemical recurrence after prostatectomy. Rectal toxicity was investigated by clinical investigation and scored according to the Common Terminology Criteria for Adverse Events. Candidate parameters were the volume of the rectum, mean dose, maximal dose, volume receiving at least 60 Gy (V 60 ), area under the DVH curve up to 25 Gy and area under the DVH curve up to 75 Gy in dependence of each chosen rectum definition. Multivariable logistic regression considered other clinical factors such as pelvine lymphatics vs local target volume, diabetes, prior rectal surgery, anticoagulation or haemorrhoids too.

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Predictors for Rectal and Intestinal Acute Toxicities During Prostate Cancer High-Dose 3D-CRT: Results of a Prospective Multicenter Study

Cited by 92 publications

References 42 publications

Physics aspects of prostate tomotherapy: Planning optimization and image-guidance issues

Physics aspects of prostate tomotherapy: Planning optimization and image-guidance issues

Image-Guided Radiation Therapy Based on Helical Tomotherapy in Prostate Cancer: Minimizing Toxicity

Comparison of different contouring definitions of the rectum as organ at risk (OAR) and dose–volume parameters predicting rectal inflammation in radiotherapy of prostate cancer: which definition to use?

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