| Anatomical and clinical predictors of acute bowel toxicity in whole pelvis irradiation for prostate cancer with Tomotherapy. | |
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MedLine Citation:
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PMID: 21864924 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: Assessing predictors of acute bowel toxicity after whole-pelvis irradiation (WPRT) Image-guided Tomotherapy with simultaneous integrated boost on prostate/prostate bed. METHODS AND MATERIALS: In the period March 2005-April 2009, 178 patients were treated with radical or adjuvant/salvage intent with WPRT Tomotherapy. Median dose to the pelvic nodes was 51.8Gy/28 fractions while concomitantly delivering 65.5-74.2Gy to prostate/prostatic bed. The impact of many anatomical and clinical parameters on ⩾Grade 2 acute bowel toxicity was investigated by logistic analyses. RESULTS: Only 15/178 patients (8.4%) experienced Grade 2 toxicity (none Grade 3). Main predictors at univariate analysis were nodal CTV (CTVN⩾380cc; OR: 3.7, p=0.017), treatment duration (<40days; OR: 6.2, p=0.006) and Grade 2 acute rectal toxicity (OR: 6.5, p=0.015). A multivariate analysis including only pre-treatment variables revealed an independent role of CTVN and age; if including treatment-related factors the best predictors were age, treatment duration and Grade 2 rectal toxicity. This last was correlated with the overlap between PTVN and loops (OVPN⩾51cc; OR: 14.4, p=0.0003) that is representative of the volume of loops receiving the prescribed dose (51.8Gy, 1.85Gy/fr). CONCLUSIONS: Acute bowel toxicity after WPRT Tomotherapy is mild, relatively rare and associated to larger CTVN and older age. While efforts to further reduce it do not appear to be relevant, the pre-treatment assessment of "high-risk" patients may help physicians in better managing symptoms. A prospective validation would be very important in confirming these results and in better refining dose-volume bowel effects including symptoms milder that the ones here investigated and retrospectively assessed. |
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Authors:
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Barbara Longobardi; Genoveffa Berardi; Claudio Fiorino; Filippo Alongi; Cesare Cozzarini; Aniko Deli; Mariangela La Macchia; Lucia Perna; Nadia Gisella Di Muzio; Riccardo Calandrino |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-22 |
Journal Detail:
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Title: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology Volume: - ISSN: 1879-0887 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8407192 Medline TA: Radiother Oncol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Medical Physics, San Raffaele Scientific Institute, Milan, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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