Toxicity Analysis of Postoperative Image-Guided Intensity-Modulated Radiotherapy for Prostate Cancer

Nath, Sameer K.; Sandhu, Ajay; Rose, Brent S.; Simpson, Daniel R.; Nobiensky, Polly D.; Wang, Jia-Zhu; Millard, Fred; Kane, Christopher J.; Parsons, J. Kellogg; Mundt, Arno J.

doi:10.1016/j.ijrobp.2009.08.023

Cited by 61 publications

(42 citation statements)

References 42 publications

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“…[7][8][9]17 Some phase II studies investigated acute toxicity in hypofractionated IMRT of the prostate bed using image-guidance, [18][19][20] but data on long-term results are lacking. In the pelvic region, 3-D prostate radiation therapy treatment plans processed with a micro-multileaf collimator provide high conformal treatments that are dosimetrically comparable with IMRT plans, but are less demanding in terms of equipment, personnel and time.…”

Section: Resultsmentioning

confidence: 99%

“…A recent retrospective study by Nath et al 7 analyzed 50 patients treated with adjuvant or salvage IMRT to a median dose of 68 Gy (range, 62-68 Gy). The prostate bed localization was obtained via planar kV imaging, performed on a daily basis using existing surgical clips as a surrogate for the prostate bed.…”

Section: Resultsmentioning

confidence: 99%

“…3 Several studies investigated acute and long-term toxicity after post-prostatectomy radiotherapy, [4][5][6] but few clinical data are available on the use of daily image guidance and of highly conformal techniques, such as intensity modulated radiotherapy (IMRT). [7][8][9][10] …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Volumetric image-guided highly conformal radiotherapy of the prostate bed: Toxicity analysis

Ingrosso

Carosi

Cristino

et al. 2017

Reports of Practical Oncology & Radiotherapy

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Volumetric image-guided highly conformal radiotherapy of the prostate bed: Toxicity analysis

Ingrosso

Carosi

Cristino

et al. 2017

Reports of Practical Oncology & Radiotherapy

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show abstract

“…Radiation-related toxicity rates were extracted from intensity-modulated radiotherapy-based studies. 14,15,18 Androgen-deprivation therapy is associated with significant acute and long-term sequelae beyond changes in libido, including increased risks of diabetes, heart disease, and osteoporotic fracture. 27 We modeled these complications in the hormone-containing arms by exposing patients to a risk of these 3 disease conditions for an additional 5 years after completing antiandrogen therapy.…”

Section: Toxicitymentioning

confidence: 99%

Primary radiotherapy versus radical prostatectomy for high‐risk prostate cancer

Parikh

Sher

2011

Cancer

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BACKGROUND: Two evidence-based therapies exist for the treatment of high-risk prostate cancer (PCA): externalbeam radiotherapy (RT) with hormone therapy (H) (RT þ H) and radical prostatectomy (S) with adjuvant radiotherapy (S þ RT). Each of these strategies is associated with different rates of local control, distant metastasis (DM), and toxicity. By using decision analysis, the authors of this report compared the quality-adjusted life expectancy (QALE) between men with high-risk PCA who received RT þ H versus S þ RT versus a hypothetical trimodality therapy (S þ RT þ H). METHODS: The authors developed a Markov model to describe lifetime health states after treatment for high-risk PCA. Probabilities and utilities were extrapolated from the literature. Toxicities after radiotherapy were based on intensity-modulated radiotherapy series, and patients were exposed to risks of diabetes, cardiovascular disease, and fracture for 5 years after completing H. Deterministic and probabilistic sensitivity analyses were performed to model uncertainty in outcome rates, toxicities, and utilities. RESULTS: RT þ H resulted in a higher QALE compared with S þ RT over a wide range of assumptions, nearly always resulting in an increase of >1 quality-adjusted life year with outcomes highly sensitive to the risk of increased all-cause mortality from H. S þ RT þ H typically was superior to RT þ H, albeit by small margins (<0.5 quality-adjusted life year), with results sensitive to assumptions about toxicity and radiotherapy efficacy. CONCLUSIONS: For men with high-risk PCA, RT þ H was superior to S þ RT, and the result was sensitive to the risk of all-cause mortality from H. Moreover, trimodality therapy may offer local and distant control benefits that lead to optimal outcomes in a meaningful population of men. Cancer 2012;118:258-

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“…Modern radiotherapy techniques include threedimensional conformal radiation therapy [1][2][3][4], intensitymodulated radiation therapy [5][6][7][8][9][10] and image-guided radiation therapy [11,12]. Current practice for radiation therapy involves optimisation of treatment plans using physical criteria (i.e.…”

mentioning

confidence: 99%

A novel correction factor based on extended volume to complement the conformity index

Jin

Wang²,

Yz³

2012

The British Journal of Radiology

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Objective: We propose a modified conformity index (MCI), based on extended volume, that improves on existing indices by correcting for the insensitivity of previous conformity indices to reference dose shape to assess the quality of high-precision radiation therapy and present an evaluation of its application. Methods: In this paper, the MCI is similar to the conformity index suggested by Paddick (CI Paddick ), but with a different correction factor. It is shown for three cases: with an extended target volume, with an extended reference dose volume and without an extended volume. Extended volume is generated by expanding the original volume by 0.1-1.1 cm isotropically. Focusing on the simulation model, measurements of MCI employ a sphere target and three types of reference doses: a sphere, an ellipsoid and a cube. We can constrain the potential advantage of the new index by comparing MCI with CI Paddick . The measurements of MCI in head-neck cancers treated with intensity-modulated radiation therapy and volumetric-modulated arc therapy provide a window on its clinical practice.Results: The results of MCI for a simulation model and clinical practice are presented and the measurements are corrected for limited spatial resolution. The three types of MCI agree with each other, and comparisons between the MCI and CI Paddick are also provided. Conclusion:The results from our analysis show that the proposed MCI can provide more objective and accurate conformity measurement for high-precision radiation therapy. In combination with a dose-volume histogram, it will be a more useful conformity index.

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Toxicity Analysis of Postoperative Image-Guided Intensity-Modulated Radiotherapy for Prostate Cancer

Cited by 61 publications

References 42 publications

Volumetric image-guided highly conformal radiotherapy of the prostate bed: Toxicity analysis

Volumetric image-guided highly conformal radiotherapy of the prostate bed: Toxicity analysis

Primary radiotherapy versus radical prostatectomy for high‐risk prostate cancer

A novel correction factor based on extended volume to complement the conformity index

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