Relationships between bladder dose-volume/surface histograms and acute urinary toxicity after radiotherapy for prostate cancer

Viviana Carillo, Cesare Cozzarini, Tiziana Rancati, Barbara Avuzzi, Andrea Botti, Valeria Casanova Borca, Gabriella Cattari, Francesco Civardi, Claudio Degli Esposti, Pierfrancesco Franco, Giuseppe Girelli, Angelo Maggio, Alessandro Muraglia, Marcella Palombarini, Alessio Pierelli, Emanuele Pignoli, Vittorio Vavassori, Michele Zeverino, Riccardo Valdagni, Claudio Fiorino

Research output: Contribution to journalArticlepeer-review


Background and purpose DUE01 is an observational study aimed at developing predictive models of genito-urinary toxicity of patients treated for prostate cancer with conventional (1.8-2 Gy/fr, CONV) or moderate hypo-fractionation (2.35-2.7 Gy/fr, HYPO). The current analysis focused on the relationship between bladder DVH/DSH and the risk of International Prostate Symptoms Score (IPSS) ≥ 15/20 at the end of radiotherapy. Materials and methods Planning and relevant clinical parameters were prospectively collected, including DVH/DSH, LQ-corrected (DVHc/DSHc) and weekly (DVHw/DSHw) histograms. Best parameters were selected by the differences between patients with/without IPSS ≥ 15/20 at the end of radiotherapy. Logistic uni- and backward multi-variable (MVA) analyses were performed. Results Data of 247 patients were available (CONV: 116, HYPO: 131). Absolute DVHw/DSHw and DVHc/DSHc predicted the risk of IPSS ≥ 15 at the end of radiotherapy (n = 77/247); an MVA model including baseline IPSS, anti-hypertensive, T stage, the absolute surface receiving ≥8.5 Gy/week and ≥12.5 Gy/week was developed (AUC = 0.78, 95% CI: 0.72-0.83). Similar AUC values were found if replacing DSHw with DVHw/DVHc/DSHc parameters. The impact of dose-volume/surface parameters remained when excluding patients with baseline IPSS ≥ 15 and in HYPO. IPSS ≥ 20 at the end of radiotherapy (n = 27/247) was mainly correlated to baseline IPSS and T stage. Conclusions Although the baseline IPSS was the main predictor, constraining v8.5w <56 cc and v12.5w <5 cc may significantly reduce acute GU toxicity.

Original languageEnglish
Pages (from-to)100-105
Number of pages6
JournalRadiotherapy and Oncology
Issue number1
Publication statusPublished - 2014


  • Dose-volume effects
  • Prostate cancer
  • Radiotherapy
  • Urinary toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology
  • Medicine(all)


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