Clinical and dosimetric predictors of late rectal toxicity after conformal radiation for localized prostate cancer: Results of a large multicenter observational study

Fellin, Gianni; Fiorino, Claudio; Rancati, T.; Vavassori, V.; Baccolini, Micaela; Bianchí, C.; Cagna, E.; Gabriele, P.; Mauro, F.; Menegotti, L.; Monti, A.F.; Stasi, M.; Valdagni, Riccardo

doi:10.1016/j.radonc.2009.09.004

Cited by 74 publications

(78 citation statements)

References 33 publications

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“…Radical radiotherapy for prostate cancer is effective but dose limited because of the proximity of normal rectal tissue [8,15]. Technological advances in dose delivery have increased the dose conformation to the target, allowing the risk of rectal toxicity to be reduced [1,3,8,26,32,34].…”

Section: Introductionmentioning

confidence: 99%

Prostate Image-Guided Radiotherapy by Megavolt Cone-Beam CT

et al. 2011

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Section: Introductionmentioning

confidence: 99%

Prostate Image-Guided Radiotherapy by Megavolt Cone-Beam CT

et al. 2011

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“…This is a controversial issue in the literature (25)(26)(27), however, we believe that in our series this finding was strongly influenced by the prescription dose which was lower in patients with prior pelvic surgery (median EQD2=70.2 vs.…”

Section: Discussionmentioning

confidence: 67%

“…in vivo 31: 961-966 (2017) 964 In our study population, VRS ≥2 occurred mostly in patients who were irradiated to the seminal vesicles (p=0.013) and who were treated with higher prescription dose (EQD2 >75 Gy; p<0.001). In these patients, larger volume of rectum usually receives higher radiation dose, thus increasing late rectal toxicity, especially rectal bleeding (25). Indeed, the volume of the rectum receiving 60 and 70 Gy as well as the mean dose delivered to the rectum are both predictors of VRS ≥2 (31).…”

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confidence: 99%

Predictive Factors of Late-onset Rectal Mucosal Changes After Radiotherapy of Prostate Cancer

Ippolito

Guido

Macchia³

et al. 2018

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“…From a clinical point of view, this approach is reasonable, as several studies have demonstrated a close relationship between acute and late rectal toxicity. 3,27,28 Although our analyses are focused on DVH parameters, the results should not be directly applied to IMRT planning and treatment for methodological reasons. IMRT allows a higher conformality in dose distribution than 3D EBRT, which is likely to influence DVH curve shapes and values.…”

Section: Discussionmentioning

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

BJR

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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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Clinical and dosimetric predictors of late rectal toxicity after conformal radiation for localized prostate cancer: Results of a large multicenter observational study

Cited by 74 publications

References 33 publications

Prostate Image-Guided Radiotherapy by Megavolt Cone-Beam CT

Prostate Image-Guided Radiotherapy by Megavolt Cone-Beam CT

Predictive Factors of Late-onset Rectal Mucosal Changes After Radiotherapy of Prostate Cancer

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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