Toxicity after post‐prostatectomy image‐guided intensity‐modulated radiotherapy using Australian guidelines

Abstract

Post-prostatectomy IG-IMRT using Australian contouring guidelines appears to have tolerable acute and late toxicity. The 4-year prevalence of grade ≥2 GU and GI toxicity was virtually unchanged compared to baseline, and sexual toxicity improved over baseline. This should reassure radiation oncologists following these guidelines. Late toxicity rates of surgery and PPRT are higher than following definitive IG-IMRT, and this should be taken into account if patients are considering surgery and likely to require PPRT.

Prostate‐specific membrane antigen positron emission tomography detected local failure after post‐prostatectomy radiation therapy: Low rates of out‐of‐field recurrence validates current Australian prostate bed contouring guidelines

“…Since 2006, all patients treated with PPRT have had the prostate bed CTV contoured using the FROGG/EviQ guidelines. 9 All of these patients had fiducial marker insertion 10 and were simulated using intravenous contrast computed tomography (CT) and planning magnetic resonance imaging (MRI) fusion, unless contraindicated (e.g., contrast allergy for CT, and non-compatible pacemaker for MRI). The planning target volume (PTV) was an expansion of 8 mm, but only allowing 7 mm expansion into the rectum.…”

Bone health assessment with dual energy X-ray absorptiometry in men with high-risk prostate carcinoma commencing adjuvant androgen deprivation therapy

“…There is sometimes debate amongst treating clinicians from different specialties about the need for bone protective therapy in both these patient groups. We have previously published on our large institutional experience regarding the diagnosis and classification of men with prostate cancer [20,21], treatment choice [22], use of ADT [23][24][25][26] and decision regret in this group [27][28][29]. In our experience, it is often difficult for patients to understand and adhere to bone protective therapy in the setting of only a short course of ADT, or in the presence of poor prognosis.…”