Evaluation of late rectal toxicity after conformal radiotherapy for prostate cancer

Cambria, Raffaella; Jereczek-Fossa, Barbara A.; Cattani, Federica; Garibaldi, Cristina; Zerini, Dario; Fodor, C.; Serafini, Flavia; Pedroli, G.; Orecchia, Roberto

doi:10.1007/s00066-009-1933-8

Cited by 15 publications

(12 citation statements)

References 54 publications

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“…Although there is no consensus concerning the rectal dose constraint, the V60 (volume receiving ≥60 Gy) has consistently demonstrated an association with a risk of Grade ≥2 rectal toxicity or rectal bleeding. Based on this study and others, the following dosimetry criteria were chosen for evaluation: V50, V60, D50, D70, D80, D90 and D100 [16-19]. …”

Section: Introductionmentioning

confidence: 99%

Application of an interstitial and biodegradable balloon system for prostate-rectum separation during prostate cancer radiotherapy: a prospective multi-center study

et al. 2013

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Background and purposeRectal toxicity presents a significant limiting factor in prostate radiotherapy regimens. This study evaluated the safety and efficacy of an implantable and biodegradable balloon specifically designed to protect rectal tissue during radiotherapy by increasing the prostate–rectum interspace.Patients and methodsBalloons were transperineally implanted, under transrectal ultrasound guidance, into the prostate–rectum interspace in 27 patients with localized prostate cancer scheduled to undergo radiotherapy. Patients underwent two simulations for radiotherapy planning--the first simulation before implant, and the second simulation seven days post implant. The balloon position, the dimensions of the prostate, and the distance between the prostate and rectum were evaluated by CT/US examinations 1 week after the implant, weekly during the radiotherapy period, and at 3 and 6 months post implant. Dose-volume histograms of pre and post implantation were compared. Adverse events were recorded throughout the study period.ResultsFour of 27 patients were excluded from the evaluation. One was excluded due to a technical failure during implant, and three patients were excluded because the balloon prematurely deflated. The balloon status was evaluated for the duration of the radiotherapy period in 23 patients. With the balloon implant, the distance between the prostate and rectum increased 10-fold, from a mean 0.22 ± 0.2 cm to 2.47 ± 0.47 cm. During the radiotherapy period the balloon length changed from 4.25 ± 0.49 cm to 3.81 ± 0.84 cm and the balloon height from 1.86 ± 0.24 cm to 1.67 ± 0.22 cm. But the prostate-rectum interspace distance remained constant from beginning to end of radiotherapy: 2.47 ± 0.47 cm and 2.41 ± 0.43 cm, respectively. A significant mean reduction in calculated rectal radiation exposure was achieved. The implant procedure was well tolerated. The adverse events included mild pain at the perineal skin and in the anus. Three patients experienced acute urinary retention which resolved in a few hours following conservative treatment. No infections or thromboembolic events occurred during the implant procedure or during the radiotherapy period.ConclusionThe transperineal implantation of the biodegradable balloon in patients scheduled to receive radiotherapy was safe and achieved a significant and constant gap between the prostate and rectum. This separation resulted in an important reduction in the rectal radiation dose. A prospective study to evaluate the acute and late rectal toxicity is needed.

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Section: Introductionmentioning

confidence: 99%

Application of an interstitial and biodegradable balloon system for prostate-rectum separation during prostate cancer radiotherapy: a prospective multi-center study

et al. 2013

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“…The correlation between single points of DVH and NTCP was previously analyzed by our group. 22 Analysis was performed in MATLAB® environment (MATLAB and Statistics Toolbox Release 2008a, MathWorks, Inc., Natick, MA).…”

Section: Surgery and Radiotherapymentioning

confidence: 99%

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

Jereczek‐Fossa

Ciardo

Ferrario

et al. 2016

BJR

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“…No specific selection criteria about urinary bladder functionality were imposed. Patients' clinical data are summarized herein: mean age, 71 years (range, 45-83 years); number of low-risk patients, 5; number of intermediate-risk patients, 12; number of high-risk patients 8; mean Gleason Score 7 (3)(4)(5)(6)(7)(8); initial PSA 11 ng/ml (range, 0.5-40 ng/ml). In one case, data to assess the risk class were not available.…”

Section: Patient Selection and Preparationmentioning

confidence: 99%

“…The details of the treatment technique were already described previously [5,13,14]. In brief, our standard treatment consists of three-dimensional (3D) conformal two-dynamic arc therapy: two lateral arcs 100° wide are employed.…”

Section: Treatment Technique and Planningmentioning

confidence: 99%

Physical and clinical implications of radiotherapy treatment of prostate cancer using a full bladder protocol

et al. 2011

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Evaluation of late rectal toxicity after conformal radiotherapy for prostate cancer

Abstract: This study demonstrated that there is an agreement between the toxicity rate evaluated by DVH constraints and by the LKB model and the clinical outcome. In this case, the use of the LKB model can be as reliable as the use of DVH constraints.

Cited by 15 publications

References 54 publications

Application of an interstitial and biodegradable balloon system for prostate-rectum separation during prostate cancer radiotherapy: a prospective multi-center study

Application of an interstitial and biodegradable balloon system for prostate-rectum separation during prostate cancer radiotherapy: a prospective multi-center study

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

Physical and clinical implications of radiotherapy treatment of prostate cancer using a full bladder protocol

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