Dosimetry and preliminary acute toxicity in the first 100 men treated for prostate cancer on a randomized hypofractionation dose escalation trial

Pollack, Alan; Hanlon, Alexandra L.; Horwitz, Eric M.; Feigenberg, Steven J.; Konski, André; Movsas, Benjamin; Greenberg, Richard E.; Uzzo, Robert G.; Charlie, C.‐M.; McNeeley, Shawn; Buyyounouski, Mark K.; Price, Robert A.

doi:10.1016/j.ijrobp.2005.07.970

Cited by 234 publications

(147 citation statements)

References 54 publications

(63 reference statements)

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“…27 Acute grade 3 and 4 toxicities were described in 0-8% of the patients. Pollack et al 28 evaluated 100 prostate cancer patients irradiated by IGRT with a total dose of 76 Gy, and only 2% of the patients suffered from severe toxicities. In our trial, severe GI and GU toxicities were reduced from 10% and 9%, respectively, to 5% by implementing IGRT without any grade 4 GU reactions.…”

Section: Discussionmentioning

confidence: 99%

Reducing radiation-associated toxicity using online image guidance (IGRT) in prostate cancer patients undergoing dose-escalated radiation therapy

Becker-Schiebe

Abaci

Ahmad

et al. 2016

Reports of Practical Oncology & Radiotherapy

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Section: Discussionmentioning

confidence: 99%

Reducing radiation-associated toxicity using online image guidance (IGRT) in prostate cancer patients undergoing dose-escalated radiation therapy

Becker-Schiebe

Abaci

Ahmad

et al. 2016

Reports of Practical Oncology & Radiotherapy

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“…Pollack [39] esetében az előfordulás ará-nya fordított volt, a normálfrakcionálású csoportban az esetek 8%-ánál, míg a hipofrakcionált csoportban 2%-ban jelentkeztek heveny tünetek. Súlyos toxicitás egyik vizsgálatban sem fordult elő.…”

Section: Akut éS Késői Gastrointestinalis Toxicitás (Normofrakcionáláunclassified

“…A normál-és hipofrakcionált csoportban Dearnaley [38] vizsgálatában 9, illetve 8%-ban, míg Pollack [39] elemzésében 56 és 48%-ban alakult ki mérsékelt urogenitalis mellék-hatás. Súlyos toxicitás nem alakult ki.…”

Section: Akut éS Késői Urogenitalis Toxicitás (Normofrakcionálás Vs unclassified

A korszerű sugárterápiás kezelések mellékhatásainak metaanalízise prosztatarákos betegeknél

et al. 2016

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Bevezetés: A sugárterápia technológiai fejlődésének egyik célterülete a prosztatarák megfelelő sugaras ellátása. Célki-tűzés: Az elemzés célja a normálfrakcionálású és a hipofrakcionált, illetve a konvencionális és a magas dózisú intenzitásmodulált sugárterápia biztonságosságának vizsgálata. Módszer: A sugárkezelés szövődményeinek gyakoriságát metaanalízissel elemezték. Eredmények: Magasabb dózisú intenzitásmodulált sugárterápiával sem a súlyos urogenitalis (akut: p = 0,9, késői: p = 0,95), sem a mérsékelt vagy súlyos gastrointestinalis (akut: N/A, késői: p = 0,08) mellékha-tásokban nincs eltérés a hagyományos besugárzási eljárásokhoz képest. A mérsékelt akut (relatív kockázat = 1,39, 95%-os konfidenciaintervallum: 1,09-1,78, p = 0,008) és késői (relatív kockázat = 1,48, 95%-os konfidenciaintervallum: 1,26-1,75, p<0,00001) urogenitalis mellékhatások relatív kockázata magasabb. A hipofrakcionált besugárzás súlyos urogenitalis (akut: N/A, késői: p = 0,73) és mérsékelt vagy súlyos gastrointestinalis (akut p = 0,73, késői p = 0,55) mellékhatásrátája sem tér el a normálfrakcionálású kezeléstől, azonban a mérsékelt késői urogenitalis mellékhatás kockázata magasabb (relatív kockázat = 1,39, 95%-os konfidenciaintervallum: 1,00-1,94, p = 0,05). Követ-keztetések: Intenzitásmodulált sugártervezés és képvezérelt kezeléskiszolgáltatás mellett a hipofrakcionált és az emelt dózisú protokoll egyaránt biztonságos. Orv. Hetil., 2016, 157(20), 776-788. Kulcsszavak: prosztatarák, sugárterápia, hipofrakcionálás, metaanalízis Meta-analysis of the side-effect profiles of modern radiation therapies for patients with prostate cancerIntroduction: One of the most relevant focus of recent developments in radiotherapy technology was the adequate irradiation of prostate cancer. Aim: The aim of this study was to analyse the safety of normo-and hypofractionated and high dose intensity-modulated radiotherapy. Method: Toxicities were identified through literature review and evidence was synthetized with meta-analytical methods. Results: The use of high dose intensity-modulated radiotherapy resulted in no difference in severe genitourinary (acute p = 0.9; late p = 0.95) and moderate or severe gastrointestinal (acute: N/A; late: p = 0.08) toxicities compared to 3D conformal radiation therapy. The risk ratio of moderate acute (RR = 1.39, 95% CI: 1.09-1.78; p = 0.008) and late genitourinary toxicities (RR = 1.48, 95% CI: 1.26-1.75; p<0,00001) was higher. There was no difference in hypo-and normofractionated intensity-modulated radiotherapy regarding severe genitourinary (acute: N/A; late: p = 0.73) and moderate or severe gastrointestinal (acute: p = 0.73; late: p = 0.55) toxicities, the risk of late moderate genitourinary toxicities was higher when using hypofractionation scheme (RR = 1.39, 95% CI: 1.00-1.94; p = 0.05). Conclusions: The use of normo-and hypofractionated and high dose intensity-modulated radiotherapy proved to be safe. However the higher risk of moderate genitourinary adverse events require an extensive clinical risk estimation.

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“…Target volumes for patients in the IMRT group have been previously described and included prostate only, prostate and seminal vesicles, or prostate and seminal vesicle and pelvic lymph nodes (19). For IMRT planning, patients were immobilized and their prostate localized in a similar fashion to those in the 3DCRT group.…”

Section: Radiation Therapymentioning

confidence: 99%

Intensity Modulated Radiation Therapy Reduces Gastrointestinal Morbidity in Patients Treated With Androgen Deprivation Therapy for Prostate Cancer

Sharma

Chen

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

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Purpose-Androgen deprivation therapy (AD) has been shown to increase late ≥ grade 2 rectal toxicity when used concurrently with three-dimensional conformal radiotherapy (3DCRT). Intensity modulated radiotherapy (IMRT) has the potential to reduce toxicity by limiting the radiation dose received by the bowel and bladder. This study compares both genitourinary (GU) and gastrointestinal (GI) toxicity in men treated with 3DCRT+AD versus IMRT+AD.Methods and Materials-From July 1992 to July 2004, 293 men received 3DCRT (n=170) or IMRT (n=123) with concurrent AD (< 6 months, n=123; ≥ 6 months, n =170). Median RT doses were 76 Gy for 3DCRT (ICRU) and 76 Gy for IMRT (95% to the PTV). Toxicity was assessed by a patient symptom questionnaire assessing toxicity completed at each visit and recorded using a modified late effects normal tissue task force radiation morbidity scale (LENT).Results-Mean follow-up was 86 months (SD=29.3) for the 3DCRT group and 40 months (SD=9.7) for the IMRT group. Acute GI toxicity (OR=4, 95% CI: 1.6-11.7, p=0.005) was significantly higher with 3DCRT than with IMRT and was independent of AD duration (i.e. <6 vs. ≥6 months). Time to development of late GI toxicity was significantly longer in the IMRT group. The 5-year Kaplan-Meier estimates for ≥ grade 2 GI toxicity were 20% for 3DCRT versus 8% for IMRT (p=0.01). On MVA, ≥ grade 2 late GI toxicity (HR=2.1, 95% CI: 1.1-4.3, p=0.04) was more prevalent in 3DCRT patients. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-Compared to 3DCRT, IMRT significantly decreased acute and late GI toxicity in patients treated with AD. NIH Public Access

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Dosimetry and preliminary acute toxicity in the first 100 men treated for prostate cancer on a randomized hypofractionation dose escalation trial

Cited by 234 publications

References 54 publications

Reducing radiation-associated toxicity using online image guidance (IGRT) in prostate cancer patients undergoing dose-escalated radiation therapy

Reducing radiation-associated toxicity using online image guidance (IGRT) in prostate cancer patients undergoing dose-escalated radiation therapy

A korszerű sugárterápiás kezelések mellékhatásainak metaanalízise prosztatarákos betegeknél

Intensity Modulated Radiation Therapy Reduces Gastrointestinal Morbidity in Patients Treated With Androgen Deprivation Therapy for Prostate Cancer

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