No increase in toxicity of pelvic irradiation when intensity modulation is employed: Clinical and dosimetric data of 208 patients treated with post-prostatectomy radiotherapy

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Abstract

Objective: To compare the toxicity of image-guided intensity-modulated radiotherapy (IG-IMRT) to the pelvis or prostate bed (PB) only. To test the hypothesis that the potentially injurious effect of pelvic irradiation can be counterbalanced by reduced irradiated normal tissue volume using IG-IMRT. Methods: Between February 2010 and February 2012, 208 patients with prostate cancer were treated with adjuvant or salvage IG-IMRT to the PB (102 patients, Group PB) or the pelvis and prostate bed (P) (106 patients, Group P). The Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria were used to evaluate toxicity. Results: Median follow-up was 27 months. Toxicity G≥2 in Group PB: in the bowel acute and late toxicities were 11.8% and 10%, respectively; urinary acute and late toxicities were 10.8% and 15%, respectively. Toxicity G≥2 in Group P: in the bowel acute and late toxicities were both 13.2%; urinary acute and late toxicities were 13.2% and 15.1%, respectively. No statistical difference in acute or late toxicity between the groups was found (bowel: p50.23 and p50.89 for acute and late toxicity, respectively; urinary: p50.39 and p50.66 for acute and late toxicity, respectively). Of the clinical variables, only previous abdominal surgery was correlated with acute bowel toxicity. Dosimetric parameters that correlated with bowel toxicity were identified. Conclusion: The toxicity rates were low and similar in both groups, suggesting that IG-IMRT allows for a safe post-operative irradiation of larger volumes. Further investigation is warranted to exclude bias owing to nonrandomized character of the study. Advances in knowledge: Our report shows that modern radiotherapy technology and careful planning allow maintaining the toxicity of pelvic lymph node treatment at the acceptable level, as it is in the case of PB radiotherapy.

Original languageEnglish
Article number20150985
JournalBritish Journal of Radiology
Volume89
Issue number1063
DOIs
Publication statusPublished - 2016

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Prostatectomy
Image-Guided Radiotherapy
Prostate
Intensity-Modulated Radiotherapy
Radiotherapy
Pelvis
Radiation Oncology
Prostatic Neoplasms
Lymph Nodes
Technology
Therapeutics
Research
Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{40d34778ba6f463bb6f822b9cb39997d,
title = "No increase in toxicity of pelvic irradiation when intensity modulation is employed: Clinical and dosimetric data of 208 patients treated with post-prostatectomy radiotherapy",
abstract = "Objective: To compare the toxicity of image-guided intensity-modulated radiotherapy (IG-IMRT) to the pelvis or prostate bed (PB) only. To test the hypothesis that the potentially injurious effect of pelvic irradiation can be counterbalanced by reduced irradiated normal tissue volume using IG-IMRT. Methods: Between February 2010 and February 2012, 208 patients with prostate cancer were treated with adjuvant or salvage IG-IMRT to the PB (102 patients, Group PB) or the pelvis and prostate bed (P) (106 patients, Group P). The Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria were used to evaluate toxicity. Results: Median follow-up was 27 months. Toxicity G≥2 in Group PB: in the bowel acute and late toxicities were 11.8{\%} and 10{\%}, respectively; urinary acute and late toxicities were 10.8{\%} and 15{\%}, respectively. Toxicity G≥2 in Group P: in the bowel acute and late toxicities were both 13.2{\%}; urinary acute and late toxicities were 13.2{\%} and 15.1{\%}, respectively. No statistical difference in acute or late toxicity between the groups was found (bowel: p50.23 and p50.89 for acute and late toxicity, respectively; urinary: p50.39 and p50.66 for acute and late toxicity, respectively). Of the clinical variables, only previous abdominal surgery was correlated with acute bowel toxicity. Dosimetric parameters that correlated with bowel toxicity were identified. Conclusion: The toxicity rates were low and similar in both groups, suggesting that IG-IMRT allows for a safe post-operative irradiation of larger volumes. Further investigation is warranted to exclude bias owing to nonrandomized character of the study. Advances in knowledge: Our report shows that modern radiotherapy technology and careful planning allow maintaining the toxicity of pelvic lymph node treatment at the acceptable level, as it is in the case of PB radiotherapy.",
author = "Jereczek-Fossa, {Barbara A.} and Delia Ciardo and Silvia Ferrario and Piero Fossati and Giuseppe Fanetti and Dario Zerini and Davide Zannoni and Cristiana Fodor and Gerardi, {Marianna A.} and Alessia Surgo and Matteo Muto and Raffaella Cambria and {De Cobelli}, Ottavio and Roberto Orecchia",
year = "2016",
doi = "10.1259/bjr.20150985",
language = "English",
volume = "89",
journal = "British Journal of Radiology",
issn = "0007-1285",
publisher = "British Institute of Radiology",
number = "1063",

}

TY - JOUR

T1 - No increase in toxicity of pelvic irradiation when intensity modulation is employed

T2 - Clinical and dosimetric data of 208 patients treated with post-prostatectomy radiotherapy

AU - Jereczek-Fossa, Barbara A.

AU - Ciardo, Delia

AU - Ferrario, Silvia

AU - Fossati, Piero

AU - Fanetti, Giuseppe

AU - Zerini, Dario

AU - Zannoni, Davide

AU - Fodor, Cristiana

AU - Gerardi, Marianna A.

AU - Surgo, Alessia

AU - Muto, Matteo

AU - Cambria, Raffaella

AU - De Cobelli, Ottavio

AU - Orecchia, Roberto

PY - 2016

Y1 - 2016

N2 - Objective: To compare the toxicity of image-guided intensity-modulated radiotherapy (IG-IMRT) to the pelvis or prostate bed (PB) only. To test the hypothesis that the potentially injurious effect of pelvic irradiation can be counterbalanced by reduced irradiated normal tissue volume using IG-IMRT. Methods: Between February 2010 and February 2012, 208 patients with prostate cancer were treated with adjuvant or salvage IG-IMRT to the PB (102 patients, Group PB) or the pelvis and prostate bed (P) (106 patients, Group P). The Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria were used to evaluate toxicity. Results: Median follow-up was 27 months. Toxicity G≥2 in Group PB: in the bowel acute and late toxicities were 11.8% and 10%, respectively; urinary acute and late toxicities were 10.8% and 15%, respectively. Toxicity G≥2 in Group P: in the bowel acute and late toxicities were both 13.2%; urinary acute and late toxicities were 13.2% and 15.1%, respectively. No statistical difference in acute or late toxicity between the groups was found (bowel: p50.23 and p50.89 for acute and late toxicity, respectively; urinary: p50.39 and p50.66 for acute and late toxicity, respectively). Of the clinical variables, only previous abdominal surgery was correlated with acute bowel toxicity. Dosimetric parameters that correlated with bowel toxicity were identified. Conclusion: The toxicity rates were low and similar in both groups, suggesting that IG-IMRT allows for a safe post-operative irradiation of larger volumes. Further investigation is warranted to exclude bias owing to nonrandomized character of the study. Advances in knowledge: Our report shows that modern radiotherapy technology and careful planning allow maintaining the toxicity of pelvic lymph node treatment at the acceptable level, as it is in the case of PB radiotherapy.

AB - Objective: To compare the toxicity of image-guided intensity-modulated radiotherapy (IG-IMRT) to the pelvis or prostate bed (PB) only. To test the hypothesis that the potentially injurious effect of pelvic irradiation can be counterbalanced by reduced irradiated normal tissue volume using IG-IMRT. Methods: Between February 2010 and February 2012, 208 patients with prostate cancer were treated with adjuvant or salvage IG-IMRT to the PB (102 patients, Group PB) or the pelvis and prostate bed (P) (106 patients, Group P). The Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria were used to evaluate toxicity. Results: Median follow-up was 27 months. Toxicity G≥2 in Group PB: in the bowel acute and late toxicities were 11.8% and 10%, respectively; urinary acute and late toxicities were 10.8% and 15%, respectively. Toxicity G≥2 in Group P: in the bowel acute and late toxicities were both 13.2%; urinary acute and late toxicities were 13.2% and 15.1%, respectively. No statistical difference in acute or late toxicity between the groups was found (bowel: p50.23 and p50.89 for acute and late toxicity, respectively; urinary: p50.39 and p50.66 for acute and late toxicity, respectively). Of the clinical variables, only previous abdominal surgery was correlated with acute bowel toxicity. Dosimetric parameters that correlated with bowel toxicity were identified. Conclusion: The toxicity rates were low and similar in both groups, suggesting that IG-IMRT allows for a safe post-operative irradiation of larger volumes. Further investigation is warranted to exclude bias owing to nonrandomized character of the study. Advances in knowledge: Our report shows that modern radiotherapy technology and careful planning allow maintaining the toxicity of pelvic lymph node treatment at the acceptable level, as it is in the case of PB radiotherapy.

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DO - 10.1259/bjr.20150985

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