Clinical and Dosimetric Predictors of Acute Toxicity After a 4-Week Hypofractionated External Beam Radiotherapy Regimen for Prostate Cancer: Results From a Multicentric Prospective Trial

Stefano Arcangeli, Lidia Strigari, Guy Soete, Gert De Meerleer, Sara Gomellini, Valerie Fonteyne, Guy Storme, Giorgio Arcangeli

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To investigate predictors for gastrointestinal (GI) and genitourinary (GU) acute toxicity after a short-course hypofractionated radiotherapy regimen for prostate cancer. Materials and Methods: Three institutions included 102 patients with T1-T3N0M0 prostate cancer in a Phase II study. Patients were treated with 56 Gy in 16 fractions over 4 weeks. Acute toxicity was scored weekly during treatment and 1 and 2 months after treatment using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria extended with additional symptoms and the International Prostate Symptom Index (IPSS). Correlation with a number of clinical and dosimetric parameters was assessed by univariate and multivariate analyses. Results: No Grade 3 or 4 GI side effects were observed. Grades 1 and 2 rectal GI toxicity occurred in 36%, and 38%, respectively. Corresponding figures for Grades 1 and 2 GU toxicity were 42% and 39%, respectively. Grade 3 or higher GU toxicity was detected in 4% of patients. In multivariate analysis, percent rectal volumes higher than 8% receiving doses ≥53 Gy (V53) were statistically correlated to Grade 2 acute rectal reaction (p = 0.006). For GU morbidity, only the IPSS pretreatment score was independently associated (p = 0.0036) with an increase in GU acute effects. Conclusions: Acute GU and GI toxicity were comparable with other series. Our data show that increased incidence and intensity of acute toxicity is a transient effect related to shorter overall treatment time rather than a larger effect in biological equivalent dose with respect to a conventional fractionation regime.

Original languageEnglish
Pages (from-to)39-45
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume73
Issue number1
DOIs
Publication statusPublished - Jan 1 2009

Keywords

  • Acute toxicity
  • BED
  • Hypofractionation
  • Prostate cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

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