The Benefits of Including Clinical Factors in Rectal Normal Tissue Complication Probability Modeling After Radiotherapy for Prostate Cancer

Defraene, Gilles; Bergh, Laura Van den; Al‐Mamgani, Abrahim; Haustermans, Karin; Heemsbergen, Wilma D.; Heuvel, Frank Van den; Lebesque, Joos V.

doi:10.1016/j.ijrobp.2011.03.056

Cited by 72 publications

(72 citation statements)

References 21 publications

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“…Reported risk factors for late rectal bleeding after radiotherapy include hypertension [32], advanced age [32, 33], larger irradiated rectal volume [34, 35], a history of a prior abdominal surgical procedure [36–40], acute toxicity (including proctitis and mucous discharge) [17, 37–39, 43, 46–53), cardiac history [40], the use of ADT [41–45], hemorrhoids [54, 55], diabetes mellitus [56–59], inflammatory bowel disease (IBD) [60]. Acute toxicity is recognized as an independent significant factor confirmed in several trials.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Nevertheless, there are several well-established significant volume effects for partial irradiation to the rectum. The volume of the rectum receiving ≥60 Gy is consistently associated with a risk of Grade ≥2 rectal toxicity or rectal bleeding [36, 40, 45, 46, 50, 51, 56, 59–65). Several studies support a correlation between Grade 2–3 bleeding and both high (volume receiving >70 Gy [V70]) and intermediate (V50–V60) doses if a higher dose (>78 Gy) was prescribed [2, 36, 46, 51, 55, 59–65].…”

Section: Literature Reviewmentioning

confidence: 99%

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Transitioning from conventional radiotherapy to intensity-modulated radiotherapy for localized prostate cancer: changing focus from rectal bleeding to detailed quality of life analysis

Yamazaki

Nakamura

Nishimura

et al. 2014

Journal of Radiation Research

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With the advent of modern radiation techniques, we have been able to deliver a higher prescribed radiotherapy dose for localized prostate cancer without severe adverse reactions. We reviewed and analyzed the change of toxicity profiles of external beam radiation therapy (EBRT) from the literature. Late rectal bleeding is the main adverse effect, and an incidence of >20% of Grade ≥2 adverse events was reported for 2D conventional radiotherapy of up to 70 Gy. 3D conformal radiation therapy (3D-CRT) was found to reduce the incidence to ∼10%. Furthermore, intensity-modulated radiation therapy (IMRT) reduced it further to a few percentage points. However, simultaneously, urological toxicities were enhanced by dose escalation using highly precise external radiotherapy. We should pay more attention to detailed quality of life (QOL) analysis, not only with respect to rectal bleeding but also other specific symptoms (such as urinary incontinence and impotence), for two reasons: (i) because of the increasing number of patients aged >80 years, and (ii) because of improved survival with elevated doses of radiotherapy and/or hormonal therapy; age is an important prognostic factor not only for prostate-specific antigen (PSA) control but also for adverse reactions. Those factors shift the main focus of treatment purpose from survival and avoidance of PSA failure to maintaining good QOL, particularly in older patients. In conclusion, the focus of toxicity analysis after radiotherapy for prostate cancer patients is changing from rectal bleeding to total elaborate quality of life assessment.

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Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Transitioning from conventional radiotherapy to intensity-modulated radiotherapy for localized prostate cancer: changing focus from rectal bleeding to detailed quality of life analysis

Yamazaki

Nakamura

Nishimura

et al. 2014

Journal of Radiation Research

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“…In order to represent modeling approaches of the analytical type, we selected a modified version of the Lyman-KutcherBurman (LKB) model [22,23] which has been generalized by including non-dosimetric dose-modifying factors (DMFs) [19,24]. DMFs increase or decrease the magnitude of the tolerance dose (TD50) parameter, resulting in lower or higher predicted normal tissue complication probability (NTCP), respectively.…”

Section: Introductionmentioning

confidence: 99%

“…DMFs increase or decrease the magnitude of the tolerance dose (TD50) parameter, resulting in lower or higher predicted normal tissue complication probability (NTCP), respectively. The generalized LKB approach has been shown to fit toxicity data significantly better than the traditional LKB model by including SNPs and other clinical variables as risk factors [19,[24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Contrasting analytical and data-driven frameworks for radiogenomic modeling of normal tissue toxicities in prostate cancer

Coates

Jeyaseelan

Ybarra

et al. 2015

Radiotherapy and Oncology

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“…Normal tissue complication probability (NTCP) is the common method to study the function of the total dose, fraction dose, fraction number and the volume of tissue exposed to the radiation in relation with occurrence of complication. Many studies have tried to described rectal complication probability, mostly using the Lyman Kutcher Burman (LKB) model [4][5]. The study of Gulliford et al [4] shown that the variation between the values derived for different endpoints may indicate different patho-physiological responses of the rectum to radiation.…”

Section: Introductionmentioning

confidence: 99%

Radiation-induced complications in prostate cancer patients treated with radiotherapy

Azuddin

Rahman²,

Siah

et al. 2014

AIP Conference Proceedings

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Abstract. The purpose of the study is to determine the relationship between radiation-induced complications with dosimetric and radiobiological parameters for prostate cancer patients that underwent the conformal radiotherapy treatment. 17 prostate cancer patients that have been treated with conformal radiotherapy were retrospectively analysed. The dosimetric data was retrieved in the form of dose-volume histogram (DVH) from Radiotherapy Treatment Planning System. The DVH was utilised to derived Normal Tissue Complication Probability (NTCP) in radiobiological data. Follow-up data from medical records were used to grade the occurrence of acute gastrointestinal (GI) and genitourinary (GU) complications using Radiation Therapy Oncology Group (RTOG) scoring system. The chi-square test was used to determine the relationship between radiation-induced complication with dosimetric and radiobiological parameters. 8 (47%) and 7 (41%) patients were having acute GI and GU complications respectively. The acute GI complication can be associated with V60 rectum , rectal mean dose and NTCP rectum with p-value of 0.016, 0.038 and 0.049 respectively. There are no significant relationships of acute GU complication with dosimetric and radiobiological variables. Further study can be done by increase the sample size and follow up duration for deeper understanding of the factors that effecting the GU and GI complication in prostate cancer radiotherapy.

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The Benefits of Including Clinical Factors in Rectal Normal Tissue Complication Probability Modeling After Radiotherapy for Prostate Cancer

Cited by 72 publications

References 21 publications

Transitioning from conventional radiotherapy to intensity-modulated radiotherapy for localized prostate cancer: changing focus from rectal bleeding to detailed quality of life analysis

Transitioning from conventional radiotherapy to intensity-modulated radiotherapy for localized prostate cancer: changing focus from rectal bleeding to detailed quality of life analysis

Contrasting analytical and data-driven frameworks for radiogenomic modeling of normal tissue toxicities in prostate cancer

Radiation-induced complications in prostate cancer patients treated with radiotherapy

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