Estimation of the Incidence of Late Bladder and Rectum Complications After High-Dose (70–78 Gy) Conformal Radiotherapy for Prostate Cancer, Using Dose–Volume Histograms

Boersma, Liesbeth; Brink, Michel; Bruce, Allison; Shouman, Tarek; Gras, Luuk; Velde, Annet te; Lebesque, Joos V.

doi:10.1016/s0360-3016(98)00037-6

Cited by 371 publications

(157 citation statements)

References 41 publications

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“…A few millimetres are more typical on a daily basis, and it is less than 1 cm (0.8 -0.9 mm) with a 95 % confidence interval (Scarborough et al, 2006;Serago et al, 2006). Therefore, 1 cm is a typical expansion around the prostate CTV to create the PTV without imaging (Hanks et al, 2000;Boersma et al, 1998). With daily ultrasound imaging, we have found that the 95 % confidence interval is reduced to 0.7 cm which agrees with Serago et al (Serago et al, 2006).…”

Section: Applications Of Ultrasound Imaging In Prostate Cancersupporting

confidence: 86%

Clinical Application of Ultrasound Imaging in Radiation Therapy

Kim¹,

Brandner²,

Huq³

et al. 2011

Ultrasound Imaging - Medical Applications

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Section: Applications Of Ultrasound Imaging In Prostate Cancersupporting

confidence: 86%

Clinical Application of Ultrasound Imaging in Radiation Therapy

Kim¹,

Brandner²,

Huq³

et al. 2011

Ultrasound Imaging - Medical Applications

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“…This finding needs further evaluation with longer follow-up periods and more patients, since it has previously been reported that neo-TAB reduces the target volume and the treated volume of risk organs (19) and has thus the potential to decrease side effects. A correlation has also been found between the volume of treated rectum and an increase in side effects (17).…”

Section: Discussionmentioning

confidence: 83%

“…These problems seem to have been resolved, since the long-term GI and GU toxicities (RTOG grade 2 Á/3) in the dose-escalated patients' side effects were 7% and 9%, respectively. A dose response has also been reported between total dose and volume of the rectal wall treated with doses above 70 Gy (17). However, the doctors have evaluated all these assessments, and patient-reported side effects are considered to detect more problems.…”

Section: Discussionmentioning

confidence: 99%

Daily-diary Evaluated Side Effects of Dose-escalation Radiotherapy of Prostate Cancer Using the Stereotactic Beamcath®R; Technique

et al. 2003

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“…This information was considered by the MRC RT01 Data Monitoring Committee and it was agreed that Trial Centres should be advised to use the smaller 1.0 cm margin (in the RT01 trial, the margin randomisation was omitted and margins of 1.0 -1.5 cm were chosen by the treating clinician). Several groups are developing models based on dose volume histograms to predict the likelihood of complications (Lu et al, 1995;Boersma et al, 1998;Fiorino et al, 2003;Jackson et al, 2001;Wachter et al, 2001). This study will add a very useful further patient data set to complement our previous studies (Fenwick et al, 2001), which will be combined with further information from the MRC RT01 trial.…”

Section: Discussionmentioning

confidence: 98%

Phase III pilot study of dose escalation using conformal radiotherapy in prostate cancer: PSA control and side effects

et al. 2005

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Radical radiotherapy is a standard form of management of localised prostate cancer. Conformal treatment planning spares adjacent normal tissues reducing treatment-related side effects and may permit safe dose escalation. We have tested the effects on tumour control and side effects of escalating radiotherapy dose and investigated the appropriate target volume margin. After an initial 3 -6 month period of androgen suppression, 126 men were randomised and treated with radiotherapy using a 2 by 2 factorial trial design. The initial radiotherapy tumour target volume included the prostate and base of seminal vesicles (SV) or complete SV depending on SV involvement risk. Treatments were randomised to deliver a dose of 64 Gy with either a 1.0 or 1.5 cm margin around the tumour volume (1.0 and 1.5 cm margin groups) and also to treat either with or without a 10 Gy boost to the prostate alone with no additional margin (64 and 74 Gy groups). Tumour control was monitored by prostate-specific antigen (PSA) testing and clinical examination with additional tests as appropriate. Acute and late side effects of treatment were measured using the Radiation Treatment and Oncology Groups (RTOG) and LENT SOM systems. The results showed that freedom from PSA failure was higher in the 74 Gy group compared to the 64 Gy group, but this did not reach conventional levels of statistical significance with 5-year actuarial control rates of 71% (95% CI 58 -81%) in the 74 Gy group vs 59% (95% CI 45 -70%) in the 64 Gy group. There were 23 failures in the 74Gy group and 33 in the 64 Gy group (Hazard ratio 0.64, 95% CI 0.38 -1.10, P ¼ 0.10). No difference in disease control was seen between the 1.0 and 1.5 cm margin groups (5-year actuarial control rates 67%, 95% CI 53 -77% vs 63%, 95% CI 50 -74%) with 28 events in each group (Hazard ratio 0.97, 95% CI 0.50 -1.86, P ¼ 0.94). Acute side effects were generally mild and 18 weeks after treatment, only four and five of the 126 men had persistent XGrade 1 bowel or bladder side effects, respectively. Statistically significant increases in acute bladder side effects were seen after treatment in the men receiving 74 Gy (P ¼ 0.006), and increases in both acute bowel side effects during treatment (P ¼ 0.05) and acute bladder sequelae (P ¼ 0.002) were recorded for men in the 1.5 cm margin group. While statistically significant, these differences were of short duration and of doubtful clinical importance. Late bowel side effects (RTOGX2) were seen more commonly in the 74 Gy and 1.5 cm margin groups (P ¼ 0.02 and P ¼ 0.05, respectively) in the first 2 years after randomisation. Similar results were found using the LENT SOM assessments. No significant differences in late bladder side effects were seen between the randomised groups using the RTOG scoring system. Using the LENT SOM instrument, a higher proportion of men treated in the 74 Gy group had Grade X3 urinary frequency at 6 and 12 months. Compared to baseline scores, bladder symptoms improved after 6 months or more follow-up in all groups. Sexual function d...

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Estimation of the Incidence of Late Bladder and Rectum Complications After High-Dose (70–78 Gy) Conformal Radiotherapy for Prostate Cancer, Using Dose–Volume Histograms

Cited by 371 publications

References 41 publications

Clinical Application of Ultrasound Imaging in Radiation Therapy

Clinical Application of Ultrasound Imaging in Radiation Therapy

Daily-diary Evaluated Side Effects of Dose-escalation Radiotherapy of Prostate Cancer Using the Stereotactic Beamcath®R; Technique

Phase III pilot study of dose escalation using conformal radiotherapy in prostate cancer: PSA control and side effects

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