Treatment of prostate cancer with intensity modulated radiation therapy (IMRT)

Novaes, P.E.R.S.; Mottas, RT; Lundgren, Msfs

doi:10.1590/1806-9282.61.01.008

Cited by 6 publications

(18 citation statements)

References 34 publications

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“…Among the available RT methods, 2D-RT has the lowest selectivity with a wide field of treatment, delivering radiation to healthy organs and, consequently, leading to higher acute and late toxicity [7]. 3D-CRT emits multiple rays of uniform intensity with the aid of computed tomography to delimit the anatomical structures and better concentrate the radiation dose over the tumour target [2,5,7]. Developed to reduce acute and late side effects, IMRT allows the delivery of radiation to the target area contour from multiple angular and modulated intensity radiation rays, offering greater radiation in areas of interest but with minimal exposure to adjacent tissues [2,5,19,20].…”

Section: Discussionmentioning

confidence: 99%

“…In Brazil, there is a high incidence among men with an estimated 68,220 new cases of prostate cancer diagnosed in 2019 [1]. The progression of PAC is usually slow and asymptomatic, with initial detection of the tumour being possible through digital rectal exams or by the measurement of serum prostate specific antigen (PSA) [1,2]. Several therapeutic modalities are used for the treatment of PAC, including radiotherapy, chemotherapy, hormone therapy and surgical removal of the tumour [1,3].…”

Section: Introductionmentioning

confidence: 99%

“…The radiation promotes cell damage, culminating in the death of neoplastic cells but also the death of non-tumour cells [6]. The radiation delivery systems have increasingly attempted to concentrate the dose of radiation only on the target volume and to reach its maximum away from the adjacent organ systems, thus minimizing the damage to non-neoplastic cells and reducing the toxicity of the treatment [2,7].…”

Section: Introductionmentioning

confidence: 99%

“…Among the irradiation techniques, two-dimensional radiotherapy or conventional radiotherapy (2D-RT), three-dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiotherapy (IMRT) have been widely used in the treatment of PAC [2]. In general, these techniques exhibit the advantages of being painless, non-invasive, and without anaesthetic risks, and these techniques can be applied to elderly patients and those with surgical contraindications [7].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, the effects of late toxicity secondary to radiotherapy may manifest months to years after the end of the treatment, significantly affecting the patient's quality of life [8]. It is known that the greater the selectivity of the technique, the safer the dose of irradiation, which minimizes the damage to the adjacent structures, such as the rectum, bladder and femoral heads [2,5,9,10]. In this context, the present study aimed to identify the secondary effects of radiotherapy on patients with PAC and to correlate these effects with the three common radiotherapy techniques, namely, 2D-RT, 3D-CRT and IMRT, and with other treatments, such as radical prostatectomy (RP) and hormonal therapy (HT).…”

Section: Introductionmentioning

confidence: 99%

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Late Side Effects after Radiation Therapy in Patients with Prostate Cancer: 2D vs 3D vs IMRT

Casaroto¹,

Pereira²,

Grubert³

et al. 2020

COR

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Introduction: Prostate adenocarcinoma (PAC) ranks sixth among the most common malignancies in the world. Acute and chronic toxicities from radiotherapy depend on both the radiation dose and the radiotherapy technique (RT), such as two-dimensional radiotherapy (2D-RT), three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). The aims of this study were to identify the secondary effects of radiotherapy on patients with PAC and to correlate these effects with the use of 2D-RT, 3D-RCT, or IMRT and with the use of other treatments, such as radical prostatectomy (RP) and hormonal therapy (HT). Methods: We selected 68 patients and collected data, such as age, type of health insurance, T and N staging, and RT used, from their medical records. Through a semi-structured instrument, the patients were interviewed about late side effects resulting from the RT treatment. Results: Most patients underwent 2D-RT (50%), and the urinary tract was the most affected system. A late effect of incontinence was related to the RP and RT treatments (P<0.05). Patients who underwent RP were more likely to develop incontinence and leakage with coughing/sneezing (P<0.01). However, the prevalence of secondary effects was not associated with a specific type of RT. Although bowel and sexual changes did not show a relationship with a specific type of RT, sexual dysfunction had an association with bowel alterations (P<0.05). Conclusions: The use of both RP and RT increased the risk of effects on bladder function. These results can contribute to the development of new research to improve RT, facilitating access to less harmful techniques, and even mitigating undesirable effects.

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