A case-control study using motion-inclusive spatial dose-volume metrics to account for genito-urinary toxicity following high-precision radiotherapy for prostate cancer Journal Article


Authors: Casares-Magaz, O.; Muren, L. P.; Pettersson, N.; Thor, M.; Hopper, A.; Knopp, R.; Deasy, J. O.; Væth, M.; Einck, J.; Moiseenko, V.
Article Title: A case-control study using motion-inclusive spatial dose-volume metrics to account for genito-urinary toxicity following high-precision radiotherapy for prostate cancer
Abstract: Background and purpose: The risk of genitourinary (GU) toxicity is dose-limiting in radiotherapy (RT) for prostate cancer. This study investigated whether motion-inclusive spatial dose/volume metrics explain the GU toxicity manifesting after high-precision RT for prostate cancer. Material and methods: A matched case-control was performed within a cohort of 258 prostate cancer patients treated with daily cone-beam CT (CBCT)-guided RT (prescription doses of 77.4–81.0 Gy). Twenty-seven patients (10.5%) presented late RTOG GU ≥ Grade 2 toxicity and those without symptoms of toxicity prior treatment (N = 7) were selected as cases. Each case was matched with three controls based on pre-treatment GU symptoms, age, Gleason score, follow-up time, and hormone therapy. Thirteen CBCTs per patient were rigidly registered to the planning CT using the recorded treatment shifts, and the bladder was manually contoured on each CBCT. Planned and actually delivered dose/volume metrics (the latter averaged across the CBCTs) were extracted from the bladder and its subsectors, and compared between cases and controls (two-way ANOVA test). Results: There were no significant differences between planned and delivered dose/volume metrics; also, there were no significant differences between cases and controls at any dose level, neither for planned nor delivered doses. The cases tended to have larger bladder volumes during treatment than controls (221 ± 71 cm3 vs 166 ± 73 cm3; p = 0.09). Conclusions: High-precision RT for prostate cancer eliminates differences between planned and delivered dose distributions. Neither planned nor delivered bladder dose/volume metrics were associated to the remaining low risk of developing GU toxicity after high-precision radiotherapy for prostate cancer. © 2018 The Authors
Keywords: controlled study; major clinical study; case control study; treatment planning; cancer patient; cancer radiotherapy; radiation dose; follow up; cohort analysis; groups by age; prostate cancer; gleason score; prescription; hormonal therapy; reproductive toxicity; cone beam computed tomography; bladder; cbct; image guided radiotherapy; genitourinary toxicity; bladder capacity; dvh; human; male; priority journal; article; spatial; measurement precision
Journal Title: Physics and Imaging in Radiation Oncology
Volume: 7
ISSN: 2405-6316
Publisher: Elsevier B.V.  
Date Published: 2018-07-01
Start Page: 65
End Page: 69
Language: English
DOI: 10.1016/j.phro.2018.09.005
PROVIDER: scopus
PMCID: PMC7807649
PUBMED: 33458407
DOI/URL:
Notes: Article -- Export Date: 4 September 2019 -- Source: Scopus
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  1. Joseph Owen Deasy
    524 Deasy
  2. Maria Elisabeth Thor
    148 Thor