The GETUG 70 Gy vs. 80 Gy randomized trial for localized prostate cancer: Feasibility and acute toxicity

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

“…The acute effects observed for the patients treated herein were comparable for the most part to those reported by others (23,(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), although there were some differences. We describe about a 48% rate of Grade 2 or higher maximum genitourinary reactions (Table 4), whereas the average in the other reports is 35% (range, 28-56%).…”

“…The drop in Grade 2 or higher acute genitourinary toxicity to <10% by 3 months after the completion of radiotherapy is noteworthy. In terms of Grade 2 or higher maximum gastrointestinal reactions, the average reported by others is about 30% (range, 14-52%) (23,(39)(40)(41)(42)(43)(44)(45)(46)(47)(48). Our finding of about 13% (Table 6) is at the low end.…”

“…Karlsdottir et al (47) and Michalski et al (54) observed that the proportion of the bladder receiving over a reference dose was an independent correlate of acute GU reactions. Beckendorf et al (45) reported that acute GU reactions were dependent on the volume of the CTV1 and PTV1. Others have not observed any target volume or normal tissue dose-volume dosimetric relationships with acute GU toxicity (23,41,46,49,53).…”

Treatment of prostate cancer with intensity modulated radiation therapy (IMRT)

“…40 The study showed a direct relationship of dose-response, which had already been suggested in previous reports and was confirmed by other authors in subsequent publications (B). [40][41][42][43] The possibility to optimize dose distribution with IMRT led to the development of studies delivering doses higher than 78-80Gy. Authors have published the results of 1,002 patients treated at doses of 86.4Gy using IMRT technique of 5 to 7 fields.…”

Proton beam therapy

“…For patients with a pretreatment PSA of more than 10 ng ml À1 , an increase in total dose from 70 to 78 Gy with conformal photons improved the biochemical disease-free survival. A French trial in which patients were randomised to receive either 70 or 80 Gy with conformal photons reported no statistical difference in acute toxicity between the two groups; they noted, respectively, 6 and 2% acute grade 3 urinary and rectal toxicities (Beckendorf et al, 2004). Intensity-modulated radiation therapy has also been used for dose escalation to the prostate while attempting to minimise toxicity by limiting radiation dose to the bladder and rectum.…”