Purpose To develop a method for investigating local dose effects on the bladder after prostate cancer radiotherapy based on dose-surface maps (DSMs). Background and purpose DSMs of patients included in a prospective study (DUE01) were generated by virtually cutting bladder contours at the points intersecting the sagittal plane passing through its center-of-mass: maps were laterally normalized and aligned at the posterior inferior point. The average DSMs of patients with/without toxicity, the DSMs of differences and t statistic were used to select regions better discriminating patients with toxicity. A total of 72 patients with no/mild urinary symptoms before radiotherapy and who were treated with moderate hypo-fractionation (2.5-2.65 Gy/fr, 70-74 Gy) were considered, and the endpoint was an International Prostate Symptoms Score (IPSS)≥15 at the end of therapy (IPSSend ≥ 15, n = 25/72). Results The DSMs of patients with/without toxicity were significantly different (p 50-70 Gy at 5-7 mm from the base was associated with an IPSSend ≥ 15 (odds ratios: 1.03-1.07). Different patterns were recognized for specific symptoms. With frequency/urgency, a quasi-threshold effect on the absolute posterior dose at 5-12 mm from the base (2 Gy equivalent doses = 80-82 Gy, α/β = 3-5 Gy) was observed. Conclusions Local-dose effects for acute symptoms were detected in a group of patients treated within a moderately hypo-fractionated protocol. The results for frequency/urgency were consistent with a threshold effect on the trigone.
- Dose-volume effects
- Prostate cancer
- Urinary toxicity
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Palorini, F., Cozzarini, C., Gianolini, S., Botti, A., Carillo, V., Iotti, C., Rancati, T., Valdagni, R., & Fiorino, C. (2016). First application of a pixel-wise analysis on bladder dose-surface maps in prostate cancer radiotherapy. Radiotherapy and Oncology, 119(1), 123 - 128. https://doi.org/10.1016/j.radonc.2016.02.025