Predicting genitourinary toxicity in three-dimensional conformal radiotherapy for localized prostate cancer: A dose-volume parameters analysis of the bladder

Paolo Bagalà, Gianluca Ingrosso, Maria Daniela Falco, Sara Petrichella, Marco D'Andrea, Maria Rago, Andrea Lancia, Claudia Bruni, Elisabetta Ponti, Riccardo Santoni

Research output: Contribution to journalArticle


PURPOSE: In prostate cancer radiotherapy, the relationship between genitourinary (GU) toxicity and clinical-dosimetric parameters is debated. We report our analysis of the parameters associated with GU toxicity.

MATERIALS AND METHODS: Eighty-six consecutive patients treated with conformal radiotherapy for localized prostate cancer were retrospectively analyzed; the bladder was delineated both as "whole bladder" (WB: Defined in its entirety as a solid organ) and "inferior bladder" (IB: Corresponding to the distal part of the bladder). GU toxicity and dose-volume parameters were correlated using the point biserial correlation coefficient. The normal tissue complication probability (NTCP) cut-off volume model was fitted to toxicity data; univariate analysis between GU toxicity and clinical parameters was done.

RESULTS: Acute GU toxicity was correlated to doses higher than 80 Gy (P < 0.05) while late GU was correlated to doses higher than 77 Gy for WB and from 77.5 Gy for IB. The NTCP cut-off volume model identified for both WB and IB a bladder volume of 6 cc receiving a dose ≥77 Gy corresponding to a 50% probability of GU toxicity. At univariate analysis, acute GU toxicity was correlated with smoke (P < 0.001).

CONCLUSION: Bladder maximal doses quantified as hotspots show a correlation to GU toxicity.

Original languageEnglish
Pages (from-to)1018-24
Number of pages7
JournalJournal of Cancer Research and Therapeutics
Issue number2
Publication statusPublished - Jul 28 2016



  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Prostatic Neoplasms
  • Radiation Injuries
  • Radiometry
  • Radiotherapy Dosage
  • Radiotherapy, Conformal
  • Urinary Bladder
  • Journal Article

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