The effect of radiation technique and bladder filling on the acute toxicity of pelvic radiotherapy for localized high risk prostate cancer

Suneil Jain, D. Andrew Loblaw, Gerard C. Morton, Cyril Danjoux, Ewa Szumacher, William Chu, Hans T. Chung, Danny Vesprini, Arjun Sahgal, Liying Zhang, Andrea Deabreu, Patrick C.F. Cheung

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)

Abstract

Purpose: The goal of this project was to see if using IMRT to deliver elective pelvic nodal irradiation (EPNI) for prostate cancer reduced acute treatment toxicity.

Methods: Two hundred and thirty patients were enrolled into prospective trials delivering EPNI with a concomitant hypofractionated IMRT boost to the prostate. During accrual, the method of EPNI delivery changed as new literature emerged. Three methods were used (1) 4FB, (2) IMRT with 2 cm CTV margins around the pelvic vessels as suggested by Shih et al. (2005) [7] (IMRT-Shih), and (3) IMRT with nodal volumes suggested by the RTOG (IMRT-RTOG). Initially patients were treated with an empty bladder, with the remainder treated with bladder full.

Results: Patients in the 4FB group had higher rates of grade 2 acute GI toxicities compared to the IMRT-Shih and IMRT-RTOG groups (31.9% vs 20.8% vs 7.2%, p = 0.0009). Patients in the 4FB group had higher rates of grade 3 urinary frequency compared to the two IMRT groups (8.5% vs 0% vs 0%, p = 0.027). However, multivariate analysis suggested the factor that most influenced toxicity was bladder filling followed by IMRT.

Conclusions: Bladder filling appeared to be the dominant factor which predicted for acute toxicity, followed by the use of IMRT.
Original languageEnglish
Pages (from-to)193-197
Number of pages5
JournalRadiotherapy and Oncology
Volume105
Issue number2
DOIs
Publication statusPublished - Nov 2012

Bibliographical note

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Keywords

  • Prostate cancer
  • IMRT
  • Acute toxicity
  • Bladder filling
  • Pelvic radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

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