Toxicity after Intensity-Modulated, Image-Guided Radiotherapy for Prostate Cancer

Abstract

High-dose radiotherapy for prostate cancer using IMRT and IGRT resulted in low rates of acute toxicity and preliminary results of late toxicity are promising.

Comparison of dosimetric parameters and acute toxicity after whole-pelvicvsprostate-only volumetric-modulated arc therapy with daily image guidance for prostate cancer

“…10,[28][29][30] Although the use of different toxicity scales makes comparison difficult, in our study, both PO and WP VMAT with daily CBCT-based IGRT provided acceptably low rates of acute GI and GU toxicity when compared with the results presented in other studies. 10,[24][25][26][27][28][29][30] Data comparing acute toxicities between WPRT and PORT in the setting of dose escalation to the prostate are limited. Table 4 summarizes the available reports in comparison with our findings.…”

“…This high-grade toxicity is potentially explained by the fact that the patients in the WPRT group were treated with threedimensional conformal radiotherapy, whereas IMRT in combination with IGRT, such as CBCT or the ultrasound-guided system for anatomic positioning verification, was used for WPRT in the other studies. 10,28 Given these findings, although there is a trend towards increased acute grade 2 GI toxicity in WPRT, it is conceivable that the incidence of severe acute GI and GU toxicities is infrequent and is similar when comparing WPRT with PORT in the setting of IMRT/VMAT using IGRT.…”

“…In terms of acute GI and GU toxicities $grade 2, the rates reported from PO IMRT series are from 1.9% to 32.4% and 9-64%, respectively. 10,[24][25][26][27][28] For WP IMRT, acute GI and GU toxicities $grade 2 have been reported from 12% to 50% and 44-51.7%, respectively. 10,[28][29][30] Although the use of different toxicity scales makes comparison difficult, in our study, both PO and WP VMAT with daily CBCT-based IGRT provided acceptably low rates of acute GI and GU toxicity when compared with the results presented in other studies.…”

“…10,[24][25][26][27][28] For WP IMRT, acute GI and GU toxicities $grade 2 have been reported from 12% to 50% and 44-51.7%, respectively. 10,[28][29][30] Although the use of different toxicity scales makes comparison difficult, in our study, both PO and WP VMAT with daily CBCT-based IGRT provided acceptably low rates of acute GI and GU toxicity when compared with the results presented in other studies. 10,[24][25][26][27][28][29][30] Data comparing acute toxicities between WPRT and PORT in the setting of dose escalation to the prostate are limited.…”

Comparison of seed brachytherapy or external beam radiotherapy (70 Gy or 74 Gy) in 919 low-risk prostate cancer patients

“…By the integration of more advanced imaging and treatment techniques such as imageguided radiotherapy or intensity-modulated radiotherapy dose is going to be increased further to achieve even better results. However by increasing dose, the risk to develop more severe acute and late toxicity also rises [1,8,9,13,24]. A reasonable effort, therefore, is to detect the dose level required within EBRT when treating low-risk prostate cancer patients in order to achieve similar excellent tumor control rates as obtained by seed BT, while not exceeding local dose too far.…”