| Does treatment of the pelvic nodes with IMRT increase late rectal toxicity over conformal prostate-only radiotherapy to 76 Gy? | |
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MedLine Citation:
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PMID: 16944377 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To compare late rectal toxicity rates after three-dimensional conformal radiotherapy to the prostate alone (P-3D-CRT) and whole-pelvis intensity-modulated radiotherapy along with a prostate boost (WP-IMRT/PB) to the same nominal total dose to the prostate. PATIENTS AND METHODS: 68 patients treated with conformal radiotherapy to the prostate only to 76 Gy at the National Institute for Cancer Research, Genoa, Italy, represented the first group (P-3D-CRT). The second group consisted of 45 patients treated at the University of Texas Medical Branch (UTMB), Galveston, TX, USA, with IMRT covering the pelvic nodes and seminal vesicles to 54 Gy at 1.8 Gy per fraction and the prostate to 60 Gy in the same 30 fractions. A separate phase boosted the prostate to 76 Gy (WP-IMRT/PB). Major aspects of planning were remarkably similar at both institutions leaving the inclusion or not of pelvic nodes as the main treatment-related difference between the two groups. Late rectal toxicity was prospectively scored according to the RTOG scale. All patients have a 12-month minimum follow-up, and mean follow-up, similar in both groups, is 25.9 months (SD [standard deviation]: 8.4 months). RESULTS: At 2 years, the estimated cumulative incidence of grade 2 late rectal toxicity is 6%+/-4% for WP-IMRT/PB and 21.2%+/-6% for P-3D-CRT (p=0.06). The difference became significant (HR [hazard ratio]=0.1, 95% CI [confidence interval]: 0.0-0.6; p=0.01) at multivariate analysis. None of the patients developed grade 3+ toxicity. CONCLUSION: Despite the larger treated volume, WP-IMRT/PB allows more rectal sparing than P-3D-CRT. |
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Authors:
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Giuseppe Sanguineti; Matthew L Cavey; Eugene J Endres; Paola Franzone; Salvina Barra; Brent C Parker; Michela Marcenaro; Martin Colman; Stefano Agostinelli; Franca Foppiano; Vito Vitale |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al] Volume: 182 ISSN: 0179-7158 ISO Abbreviation: Strahlenther Onkol Publication Date: 2006 Sep |
Date Detail:
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Created Date: 2006-08-31 Completed Date: 2006-11-03 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8603469 Medline TA: Strahlenther Onkol Country: Germany |
Other Details:
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Languages: eng Pagination: 543-9 Citation Subset: IM |
Affiliation:
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Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX 77555-0711, USA. gisangui@utmb.edu |
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| MeSH Terms | |
Descriptor/Qualifier:
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Actuarial Analysis Aged Data Interpretation, Statistical Dose Fractionation Follow-Up Studies Humans Lymph Nodes / radiation effects* Male Pelvis Prospective Studies Prostatic Neoplasms / radiotherapy* Radiotherapy Dosage* Radiotherapy, Conformal* Radiotherapy, Intensity-Modulated* Rectum / radiation effects* Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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