Significant reduction of acute toxicity following pelvic irradiation with Helical Tomotherapy in patients with localized prostate cancer

Cozzarini, C.; Fiorino, Claudio; Muzio, N. Di; Alongi, Filippo; Broggi, S.; Cattaneo, M.; Montorsi, Francesco; Rigatti, Patrìzio; Calandrino, R.; Fazio, Ferruccio

doi:10.1016/j.radonc.2007.07.013

Cited by 86 publications

(55 citation statements)

References 43 publications

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“…Our approach in optimizing HT was also particularly efficient in the treatment of pelvic nodes, translating in a dramatic reduction of acute bowel and bladder toxicity compared to conventional box technique [2]. The availability of IMRT combined with planning approaches as the one followed at our Institution may drastically and rapidly change the attitude of a number of physicians who may be reluctant to extend pelvis irradiation in their clinical practice due to the relatively bad impact on quality of life of 4-fields box technique, especially due to upper GI toxicity [19].…”

Section: Discussionmentioning

confidence: 98%

“…Part of them were enrolled in the TOMOSIB (n 036) while the remaining were irradiated for adjuvant/salvage intent while concomitantly delivering 65.5Á72 Gy in 25Á30 fractions to the prostatic bed. Due to the peculiar ability of HT in dramatically sparing the intestinal cavity, planning data referred to pelvis irradiation were recently reviewed [2], independently on the treatment intent. These data were compared with a cohort of patients treated in the same period (2004Á2007) with conventional box-technique and with 5-fields IMRT with dynamic MLC (Varian system, EclipseHelios'DHX Linac); dose-volume information was also correlated with acute upper GI toxicity.…”

Section: Pelvic Nodes Tomotherapymentioning

confidence: 99%

“…Planning data referred to the first 50 patients have recently been reviewed [2]. In summary, a very low mean rectal dose was obtained (median value: 26.5 Gy) with V55 ranging between 5 and 14 %.…”

Section: Tomoadv Patients: Planning Datamentioning

confidence: 99%

“…Up to now more than 250 patients were treated and first clinical results concerning acute and early late toxicity have been published [2,3].…”

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confidence: 99%

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Physics aspects of prostate tomotherapy: Planning optimization and image-guidance issues

et al. 2008

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Section: Discussionmentioning

confidence: 98%

Section: Pelvic Nodes Tomotherapymentioning

confidence: 99%

Section: Tomoadv Patients: Planning Datamentioning

confidence: 99%

“…Up to now more than 250 patients were treated and first clinical results concerning acute and early late toxicity have been published [2,3].…”

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confidence: 99%

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Physics aspects of prostate tomotherapy: Planning optimization and image-guidance issues

et al. 2008

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“…However, several techniques have emerged with efficient dose delivery and assurance of local control, while sparing healthy organs: first 3D-conformal radiotherapy (3D-CRT), then intensity-modulated radiotherapy (IMRT), and finally helical tomotherapy (HT) [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Craniospinal Irradiation (CSI) in Acute Lymphoblastic Leukemia: Comparison between Conformal Radiotherapy, Intensity-Modulated Radiotherapy, and Helical Tomotherapy (HT)

Jacob¹,

JP²,

Chira³

2012

J Nucl Med Radiat Ther

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Predictive models of toxicity in external radiotherapy

Fiorino

Rancati

Valdagni

2009

Cancer

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Dose-volume modeling of late and acute toxicity in radiotherapy for prostate cancer is a rapidly evolving field of investigation. The availability of individual, 3-dimensional dose distribution and dose-volume histograms (DVHs) permits the quantitative assessment of dose-volume relations for specific endpoints by investigating the correlation between individual dose-volume data and clinical outcomes. These studies often entail a huge effort in collecting data from large populations that have been followed properly for long time. The rectum is the most investigated organ, especially concerning late bleeding, and a good consensus regarding serial-like behavior for this endpoint comes from various investigations. Concerning the bladder, the existence of a clear dose effect when the organ is wholly or partially irradiated is well known. Concerning erectile dysfunctions, the wide use of hormone therapy and drugs against impotence suggests that large, prospectively scored populations will be necessary to definitively assess dose-volume relations.Bowel irradiation during prostate cancer radiotherapy occurs during pelvic lymph node irradiation, and severe acute toxicity has yet to be modeled clearly. Evidence of a correlation between the DVH of the intestinal cavity and bowel toxicity recently was reported, providing important information about optimal dose-volume constraints to be used during whole-pelvis irradiation with intensity-modulated radiotherapy. KEY WORDS: radiotherapy, radiation-induced effects, toxicity, dose-volume models.Dose-volume modeling of late and acute toxicity in the radiotherapy of prostate cancer is a rapidly evolving field of investigation. The prostate is in close proximity to organs at risk, such as the rectum and bladder, which should be spared as much as possible; conversely, evidence of a dose-effect relation in the probability of local control, at least in some subgroups of patients, suggests the advisability of escalation to very high doses. Intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT) exploit new tools and methods for dose painting distributions strictly tailored around the planning target volumes (PTV) to reduce the fraction of organs at risk irradiated to moderate/high doses while escalating the dose and/or the dose per fraction.

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Significant reduction of acute toxicity following pelvic irradiation with Helical Tomotherapy in patients with localized prostate cancer

Cited by 86 publications

References 43 publications

Physics aspects of prostate tomotherapy: Planning optimization and image-guidance issues

Physics aspects of prostate tomotherapy: Planning optimization and image-guidance issues

Craniospinal Irradiation (CSI) in Acute Lymphoblastic Leukemia: Comparison between Conformal Radiotherapy, Intensity-Modulated Radiotherapy, and Helical Tomotherapy (HT)

Predictive models of toxicity in external radiotherapy

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