Comparative Toxicity and Dosimetric Profile of Whole-Pelvis Versus Prostate Bed-Only Intensity-Modulated Radiation Therapy After Prostatectomy

Phase 2 trial of guideline-based postoperative image guided intensity modulated radiation therapy for prostate cancer: Toxicity, biochemical, and patient-reported health-related quality-of-life outcomes

“…Nonetheless, acute toxicity outcomes in this study were comparable to other previously reported series that used IG-IMRT postoperatively. [25][26][27][28][29][30][31] This work e478 expands on previous literature by reporting long-term GI and GU toxicities, which reassuringly remained low when strict rectal dose objectives were applied. As shown in Table 4, the literature regarding patientreported outcomes related to treatment toxicities and HRQOL in the postprostatectomy setting is limited.…”

ACR Appropriateness Criteria ® external beam radiation therapy treatment planning for clinically localized prostate cancer, part I of II

“…If SV involvement is evident, the SV remnants should also be included in the PF-CTV 66 . Although there is some evidence that pelvic nodal irradiation may improve disease control for patients with high-risk prostate cancer after prostatectomy,68, 69 the addition of pelvic nodal irradiation may increase the risk of treatment-related toxicities compared with treating the prostate bed alone 70 . Whether to include pelvic LNs in postprostatectomy RT is an unresolved question and is being evaluated by the RTOG cooperative group in a phase 3 randomized controlled trial (RTOG 0534) 71 …”

No increase in toxicity of pelvic irradiation when intensity modulation is employed: clinical and dosimetric data of 208 patients treated with post-prostatectomy radiotherapy

“…This difference may at least partially explain the results of Van Praet et al's study: 24 acute and late lower intestinal toxicity was significantly higher following pelvic IMRT (acute G2 toxicity is 42% in whole pelvis vs 15% in PB-only irradiation; late G2 toxicity is 30% in the whole pelvis vs 15% in PB-only irradiation), while acute and late urinary toxicity was similar in both groups (acute toxicity G $ 2 is 40% in whole pelvis vs 29% in PB-only irradiation; late toxicity G $ 2 is 50% in whole pelvis vs 35% in PB-only irradiation). Deville et al 25 in their retrospective study on 67 patients found a significant increase only in acute bowel toxicity (61% vs 29% G $ 2 toxicity in whole pelvis irradiation and PB-only irradiation, respectively), and no difference in late bowel toxicity (3% vs 0%) or acute (22% vs 7%) and late (17% vs 13%) urinary events, when pelvic IMRT was compared with PB-only IMRT. As in our study, the presacral area was not included.…”

“…24,25 There are several reports regarding pelvic irradiation in the radical setting with an intact prostate [26][27][28] or comparing pelvic IMRT with pelvic 3DCRT. [29][30][31][32] In radical series, the majority of the retrospective analyses showed some increase in acute toxicity (principally GI rather than GU) with pelvic radiotherapy.…”