Abstract
Aims: To retrospectively evaluate and compare the incidence of acute genitourinary (aGU), upper gastrointestinal (uGI) and rectal (lGI) injuries after radiotherapy with hypofractionation by volumetric modulation arc therapy (VMAT, the Hypo-RapidArc group) and conventional fractionation by three-dimensional conformal radiotherapy (3DCRT) in patients with localized prostate cancer treated, after radical prostatectomy, with prostatic bed irradiation. Patients and Methods: Between 2007 and 2012, 84 consecutive patients with clinically localized prostate cancer submitted to radical prostatectomy were also treated with irradiation to the prostate bed. Forty-five received 3DCRT and 39 Hypo-RapidArc. The median age was 67 and 69 years for 3DCRT and Hypo-RapidArc groups respectively. The median dose to the prostatic bed was 70 Gy in both groups: 2 Gy/fraction in the 3DCRT group and 2.5 Gy/fraction in the Hypo-RapidArc group. After radical prostatectomy, the median time-to-RT was 15 and 16 months respectively. Acute and late toxicities were scored according to the Radiation Therapy and Oncology Group/European Organization for Research and Treatment of Cancer system. Results: Grade 2aGU was recorded in 16% of cases in the 3DRCT group and in 10% in the Hypo-RapidArc group. No acute grade 2 upper gastrointestinal (uGI) toxicities were found in the 3DCRT versus 5% in the Hypo-RapidArc group. The incidence of grade 2 lower gastrointestinal (lGI) toxicities was 22% in the 3DCRT group versus 15% in the Hypo-RapidArc group. No grade 3 or greater toxicities were found in either group. In both groups, good planning target volume coverage was achieved: V95% was recorded as 96.3±3.6% (mean±standard deviation) and 95.7±8.9 for the 3DRCT and the Hypo-RapidArc groups, respectively. The mean rectal volume dose receiving at least 70 Gy was 9.1±10.8% and 0.1±0.6% respectively. The mean dose to the bladder was 49.5±12.3 Gy and 37.2±5.2 Gy respectively. Significant correlation between late rectal toxicity and the maximum dose to the rectum, V70Gy, was found in the 3DCRT group, while no significant correlations were found for acute toxicity. Conclusion: The results presented in this study demonstrate the feasibility of a moderate hypo-fractionation regimen with RapidArc in the postoperative setting. Longer-term data are needed to confirm late toxicity profiles.
| Original language | English |
|---|---|
| Pages (from-to) | 4537-4544 |
| Number of pages | 8 |
| Journal | Anticancer Research |
| Volume | 33 |
| Issue number | 10 |
| Publication status | Published - Oct 2013 |
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Keywords
- Hypofractionation
- Prostate cancer
- RapidArc
- VMAT
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Hypofractionation with VMAT versus 3DCRT in post-operative patients with prostate cancer. / Alongi, Filippo; Cozzi, Luca; Fogliata, Antonella; Iftode, Cristina; Comito, Tiziana; Clivio, Alessandro; Villa, Elisa; Lobefalo, Francesca; Navarria, Piera; Reggiori, Giacomo; Mancosu, Pietro; Clerici, Elena; Tomatis, Stefano; Taverna, Gianluigi; Graziotti, Pierpaolo; Scorsetti, Marta.
In: Anticancer Research, Vol. 33, No. 10, 10.2013, p. 4537-4544.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hypofractionation with VMAT versus 3DCRT in post-operative patients with prostate cancer
AU - Alongi, Filippo
AU - Cozzi, Luca
AU - Fogliata, Antonella
AU - Iftode, Cristina
AU - Comito, Tiziana
AU - Clivio, Alessandro
AU - Villa, Elisa
AU - Lobefalo, Francesca
AU - Navarria, Piera
AU - Reggiori, Giacomo
AU - Mancosu, Pietro
AU - Clerici, Elena
AU - Tomatis, Stefano
AU - Taverna, Gianluigi
AU - Graziotti, Pierpaolo
AU - Scorsetti, Marta
PY - 2013/10
Y1 - 2013/10
N2 - Aims: To retrospectively evaluate and compare the incidence of acute genitourinary (aGU), upper gastrointestinal (uGI) and rectal (lGI) injuries after radiotherapy with hypofractionation by volumetric modulation arc therapy (VMAT, the Hypo-RapidArc group) and conventional fractionation by three-dimensional conformal radiotherapy (3DCRT) in patients with localized prostate cancer treated, after radical prostatectomy, with prostatic bed irradiation. Patients and Methods: Between 2007 and 2012, 84 consecutive patients with clinically localized prostate cancer submitted to radical prostatectomy were also treated with irradiation to the prostate bed. Forty-five received 3DCRT and 39 Hypo-RapidArc. The median age was 67 and 69 years for 3DCRT and Hypo-RapidArc groups respectively. The median dose to the prostatic bed was 70 Gy in both groups: 2 Gy/fraction in the 3DCRT group and 2.5 Gy/fraction in the Hypo-RapidArc group. After radical prostatectomy, the median time-to-RT was 15 and 16 months respectively. Acute and late toxicities were scored according to the Radiation Therapy and Oncology Group/European Organization for Research and Treatment of Cancer system. Results: Grade 2aGU was recorded in 16% of cases in the 3DRCT group and in 10% in the Hypo-RapidArc group. No acute grade 2 upper gastrointestinal (uGI) toxicities were found in the 3DCRT versus 5% in the Hypo-RapidArc group. The incidence of grade 2 lower gastrointestinal (lGI) toxicities was 22% in the 3DCRT group versus 15% in the Hypo-RapidArc group. No grade 3 or greater toxicities were found in either group. In both groups, good planning target volume coverage was achieved: V95% was recorded as 96.3±3.6% (mean±standard deviation) and 95.7±8.9 for the 3DRCT and the Hypo-RapidArc groups, respectively. The mean rectal volume dose receiving at least 70 Gy was 9.1±10.8% and 0.1±0.6% respectively. The mean dose to the bladder was 49.5±12.3 Gy and 37.2±5.2 Gy respectively. Significant correlation between late rectal toxicity and the maximum dose to the rectum, V70Gy, was found in the 3DCRT group, while no significant correlations were found for acute toxicity. Conclusion: The results presented in this study demonstrate the feasibility of a moderate hypo-fractionation regimen with RapidArc in the postoperative setting. Longer-term data are needed to confirm late toxicity profiles.
AB - Aims: To retrospectively evaluate and compare the incidence of acute genitourinary (aGU), upper gastrointestinal (uGI) and rectal (lGI) injuries after radiotherapy with hypofractionation by volumetric modulation arc therapy (VMAT, the Hypo-RapidArc group) and conventional fractionation by three-dimensional conformal radiotherapy (3DCRT) in patients with localized prostate cancer treated, after radical prostatectomy, with prostatic bed irradiation. Patients and Methods: Between 2007 and 2012, 84 consecutive patients with clinically localized prostate cancer submitted to radical prostatectomy were also treated with irradiation to the prostate bed. Forty-five received 3DCRT and 39 Hypo-RapidArc. The median age was 67 and 69 years for 3DCRT and Hypo-RapidArc groups respectively. The median dose to the prostatic bed was 70 Gy in both groups: 2 Gy/fraction in the 3DCRT group and 2.5 Gy/fraction in the Hypo-RapidArc group. After radical prostatectomy, the median time-to-RT was 15 and 16 months respectively. Acute and late toxicities were scored according to the Radiation Therapy and Oncology Group/European Organization for Research and Treatment of Cancer system. Results: Grade 2aGU was recorded in 16% of cases in the 3DRCT group and in 10% in the Hypo-RapidArc group. No acute grade 2 upper gastrointestinal (uGI) toxicities were found in the 3DCRT versus 5% in the Hypo-RapidArc group. The incidence of grade 2 lower gastrointestinal (lGI) toxicities was 22% in the 3DCRT group versus 15% in the Hypo-RapidArc group. No grade 3 or greater toxicities were found in either group. In both groups, good planning target volume coverage was achieved: V95% was recorded as 96.3±3.6% (mean±standard deviation) and 95.7±8.9 for the 3DRCT and the Hypo-RapidArc groups, respectively. The mean rectal volume dose receiving at least 70 Gy was 9.1±10.8% and 0.1±0.6% respectively. The mean dose to the bladder was 49.5±12.3 Gy and 37.2±5.2 Gy respectively. Significant correlation between late rectal toxicity and the maximum dose to the rectum, V70Gy, was found in the 3DCRT group, while no significant correlations were found for acute toxicity. Conclusion: The results presented in this study demonstrate the feasibility of a moderate hypo-fractionation regimen with RapidArc in the postoperative setting. Longer-term data are needed to confirm late toxicity profiles.
KW - Hypofractionation
KW - Prostate cancer
KW - RapidArc
KW - VMAT
UR - http://www.scopus.com/inward/record.url?scp=84891352184&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84891352184&partnerID=8YFLogxK
M3 - Article
C2 - 24123027
AN - SCOPUS:84891352184
VL - 33
SP - 4537
EP - 4544
JO - Anticancer Research
JF - Anticancer Research
SN - 0250-7005
IS - 10
ER -