open access

Vol 25, No 4 (2020)
Original research articles
Published online: 2020-07-01
Submitted: 2020-01-06
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Transitioning from conformal radiotherapy to intensity-modulated radiotherapy after radical prostatectomy: Clinical benefit, oncologic outcomes and incidence of gastrointestinal and urinary toxicities

C.H. Flores-Balcázar, D.M. Urías-Arce, M.T. Bourlon, F. Gabilondo-Navarro, S.I. Pérez-Álvarez, R. Ramos-Prudencio, F. Rodríguez-Covarrubias
DOI: 10.1016/j.rpor.2020.04.018
·
Rep Pract Oncol Radiother 2020;25(4):568-573.

open access

Vol 25, No 4 (2020)
Original research articles
Published online: 2020-07-01
Submitted: 2020-01-06

Abstract

Aim

The purpose of this study was to review genitourinary (GU) and gastrointestinal (GI) toxicity associated with high-dose radiotherapy (RT) delivered with 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) or volumetric arc therapy (VMAT) following radical prostatectomy (RP).

Background

RP is a therapeutic option for the management of prostate cancer (PrCa). When assessing postoperative RT techniques for PrCa, the published literature focuses on patients treated with 2-dimensional conventional methods without reflecting the implementation of 3D-CRT, IMRT, or VMAT.

Materials and methods

A total of 83 patients were included in this analysis; 30 patients received 3D-CRT, and 53 patients received IMRT/VMAT. Acute and late symptoms of the GU and lower GI tract were retrospectively graded according to the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer radiation toxicity grading systems. The relapse failure-free rate and overall survival were also evaluated.

Results

The rate of acute GU toxicity was 9.4% vs. 13.3% for the IMRT/VMAT and 3D-CRT groups (p = 0.583). The 5-year actuarial rates of late GI toxicity for IMRT/VMAT and 3D-CRT treatments were 1.9% and 6.7%, respectively. The rate of late GU toxicity for the IMRT/VMAT and 3D-CRT treatment groups was 7.5% and 16.6%, respectively (p = 0.199). We found no association between acute or late toxicity and the RT technique in univariate and multivariate analyses.

Conclusion

Postprostatectomy IMRT/VMAT and 3D-CRT achieved similar morbidity and cancer control outcomes. The clinical benefit of highly conformal techniques in this setting is unclear although formal analysis is needed.

Abstract

Aim

The purpose of this study was to review genitourinary (GU) and gastrointestinal (GI) toxicity associated with high-dose radiotherapy (RT) delivered with 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) or volumetric arc therapy (VMAT) following radical prostatectomy (RP).

Background

RP is a therapeutic option for the management of prostate cancer (PrCa). When assessing postoperative RT techniques for PrCa, the published literature focuses on patients treated with 2-dimensional conventional methods without reflecting the implementation of 3D-CRT, IMRT, or VMAT.

Materials and methods

A total of 83 patients were included in this analysis; 30 patients received 3D-CRT, and 53 patients received IMRT/VMAT. Acute and late symptoms of the GU and lower GI tract were retrospectively graded according to the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer radiation toxicity grading systems. The relapse failure-free rate and overall survival were also evaluated.

Results

The rate of acute GU toxicity was 9.4% vs. 13.3% for the IMRT/VMAT and 3D-CRT groups (p = 0.583). The 5-year actuarial rates of late GI toxicity for IMRT/VMAT and 3D-CRT treatments were 1.9% and 6.7%, respectively. The rate of late GU toxicity for the IMRT/VMAT and 3D-CRT treatment groups was 7.5% and 16.6%, respectively (p = 0.199). We found no association between acute or late toxicity and the RT technique in univariate and multivariate analyses.

Conclusion

Postprostatectomy IMRT/VMAT and 3D-CRT achieved similar morbidity and cancer control outcomes. The clinical benefit of highly conformal techniques in this setting is unclear although formal analysis is needed.

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Keywords

Prostate cancer; Postoperative radiotherapy; Urinary toxicity; Gastrointestinal toxicity; 3D-CRT; ADT; ART; BCR; CBCT; CTV; EORTC; GI; GU; IMRT; NCCN; OS; PrCa; PSA; RFF; RP; RT; RTOG; SRT; VMAT

About this article
Title

Transitioning from conformal radiotherapy to intensity-modulated radiotherapy after radical prostatectomy: Clinical benefit, oncologic outcomes and incidence of gastrointestinal and urinary toxicities

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 4 (2020)

Pages

568-573

Published online

2020-07-01

DOI

10.1016/j.rpor.2020.04.018

Bibliographic record

Rep Pract Oncol Radiother 2020;25(4):568-573.

Keywords

Prostate cancer
Postoperative radiotherapy
Urinary toxicity
Gastrointestinal toxicity
3D-CRT
ADT
ART
BCR
CBCT
CTV
EORTC
GI
GU
IMRT
NCCN
OS
PrCa
PSA
RFF
RP
RT
RTOG
SRT
VMAT

Authors

C.H. Flores-Balcázar
D.M. Urías-Arce
M.T. Bourlon
F. Gabilondo-Navarro
S.I. Pérez-Álvarez
R. Ramos-Prudencio
F. Rodríguez-Covarrubias

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