open access

Vol 23, No 5 (2018)
Original research articles
Published online: 2018-09-01
Submitted: 2018-01-24
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Volumetric image-guided conformal radiotherapy for localized prostate cancer: Analysis of dosimetric and clinical factors affecting acute and late toxicity

Gianluca Ingrosso, Alessandra Carosi, Daniela di Cristino, Elisabetta Ponti, Andrea Lancia, Marta Bottero, Alessandro Cancelli, Alessandra Murgia, Irene Turturici, Riccardo Santoni
DOI: 10.1016/j.rpor.2018.07.010
·
Rep Pract Oncol Radiother 2018;23(5):315-321.

open access

Vol 23, No 5 (2018)
Original research articles
Published online: 2018-09-01
Submitted: 2018-01-24

Abstract

Aim

To identify factors influencing toxicity in patients affected by localized prostate cancer treated with conformal image-guided radiotherapy.

Background

Image guidance in combination with conformal techniques is the standard of care in localized prostate cancer, but factors affecting toxicity are still under investigation.

Materials and methods

294 patients were analyzed. Median age at diagnosis was 71 year. 76 Gy (38 × 2 Gy) were delivered to the target volume. We used the χ2 test to analyse associations between toxicity and dosimetric and clinical parameters. Multivariate analysis was performed using binary logistic regression. Kaplan–Meier method was used for survival analysis.

Results

Median follow-up was 62.9 months. Acute grade ≥2 gastro-intestinal toxicity (GI) was 12.1%. Acute genito-urinary (GU) toxicity of grade ≥2 was 33.9%. Actuarial 4 and 5 years late grade ≥2 GI was 3% and 4%, respectively. Four and 5-year late grade ≥2 GU toxicity was 6% and 10%. At multivariate analysis for acute toxicity rectal V70 was correlated with GI toxicity (p = 0.01, HR 2.73 CI 1.19–6.26), and smoking habit with GU toxicity (p < 0.01, HR 2.50 CI 1.51–4.14). For late toxicity, rectal V70 was correlated with gastro-intestinal toxicity (p = 0.04, HR 4.76 CI 1.07–21.13), and pre-radiotherapy urinary symptoms with genito-urinary toxicity (p = 0.01, HR 2.84 CI 1.29–6.22).

Discussion

Conformal image-guided radiotherapy shows low rates of toxicity. Smoking should be avoided during radiotherapy. Besides the evaluation of high doses received by the organs at risk, individual factors, such as co-morbidities and lifestyle choices, have an impact on normal-tissue complication risk.

Abstract

Aim

To identify factors influencing toxicity in patients affected by localized prostate cancer treated with conformal image-guided radiotherapy.

Background

Image guidance in combination with conformal techniques is the standard of care in localized prostate cancer, but factors affecting toxicity are still under investigation.

Materials and methods

294 patients were analyzed. Median age at diagnosis was 71 year. 76 Gy (38 × 2 Gy) were delivered to the target volume. We used the χ2 test to analyse associations between toxicity and dosimetric and clinical parameters. Multivariate analysis was performed using binary logistic regression. Kaplan–Meier method was used for survival analysis.

Results

Median follow-up was 62.9 months. Acute grade ≥2 gastro-intestinal toxicity (GI) was 12.1%. Acute genito-urinary (GU) toxicity of grade ≥2 was 33.9%. Actuarial 4 and 5 years late grade ≥2 GI was 3% and 4%, respectively. Four and 5-year late grade ≥2 GU toxicity was 6% and 10%. At multivariate analysis for acute toxicity rectal V70 was correlated with GI toxicity (p = 0.01, HR 2.73 CI 1.19–6.26), and smoking habit with GU toxicity (p < 0.01, HR 2.50 CI 1.51–4.14). For late toxicity, rectal V70 was correlated with gastro-intestinal toxicity (p = 0.04, HR 4.76 CI 1.07–21.13), and pre-radiotherapy urinary symptoms with genito-urinary toxicity (p = 0.01, HR 2.84 CI 1.29–6.22).

Discussion

Conformal image-guided radiotherapy shows low rates of toxicity. Smoking should be avoided during radiotherapy. Besides the evaluation of high doses received by the organs at risk, individual factors, such as co-morbidities and lifestyle choices, have an impact on normal-tissue complication risk.

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Keywords

Cone-beam CT; Conformal radiotherapy; Prostate cancer; Toxicity; Volumetric image-guidance

About this article
Title

Volumetric image-guided conformal radiotherapy for localized prostate cancer: Analysis of dosimetric and clinical factors affecting acute and late toxicity

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 23, No 5 (2018)

Pages

315-321

Published online

2018-09-01

DOI

10.1016/j.rpor.2018.07.010

Bibliographic record

Rep Pract Oncol Radiother 2018;23(5):315-321.

Keywords

Cone-beam CT
Conformal radiotherapy
Prostate cancer
Toxicity
Volumetric image-guidance

Authors

Gianluca Ingrosso
Alessandra Carosi
Daniela di Cristino
Elisabetta Ponti
Andrea Lancia
Marta Bottero
Alessandro Cancelli
Alessandra Murgia
Irene Turturici
Riccardo Santoni

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