Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer Journal Article
| Authors: | Zelefsky, M. J.; Levin, E. J.; Hunt, M.; Yamada, Y.; Shippy, A. M.; Jackson, A.; Amols, H. I. |
| Article Title: | Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer |
| Abstract: | Purpose: To report the incidence and predictors of treatment-related toxicity at 10 years after three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) for localized prostate cancer. Methods and Materials: Between 1988 and 2000, 1571 patients with stages T1-T3 prostate cancer were treated with 3D-CRT/IMRT with doses ranging from 66 to 81 Gy. The median follow-up was 10 years. Posttreatment toxicities were all graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events. Results: The actuarial likelihood at 10 years for the development of Grade ≥2 GI toxicities was 9%. The use of IMRT significantly reduced the risk of gastrointestinal (GI) toxicities compared with patients treated with conventional 3D-CRT (13% to 5%; p < 0.001). Among patients who experienced acute symptoms the 10-year incidence of late toxicity was 42%, compared with 9% for those who did not experience acute symptoms (p < 0.0001). The 10-year incidence of late Grade ≥2 genitourinary (GU) toxicity was 15%. Patients treated with 81 Gy (IMRT) had a 20% incidence of GU symptoms at 10 years, compared with a 12% for patient treated to lower doses (p = 0.01). Among patients who had developed acute symptoms during treatment, the incidence of late toxicity at 10 years was 35%, compared with 12% (p < 0.001). The incidence of Grade 3 GI and GU toxicities was 1% and 3%, respectively. Conclusions: Serious late toxicity was unusual despite the delivery of high radiation dose levels in these patients. Higher doses were associated with increased GI and GU Grade 2 toxicities, but the risk of proctitis was significantly reduced with IMRT. Acute symptoms were a precursor of late toxicities in these patients. © 2008 Elsevier Inc. All rights reserved. |
| Keywords: | adult; controlled study; aged; aged, 80 and over; middle aged; major clinical study; three dimensional; intensity modulated radiation therapy; cancer radiotherapy; radiation dose; follow-up studies; cancer incidence; gastrointestinal symptom; radiotherapy dosage; radiotherapy; incidence; oncology; time factors; prostate cancer; prostatic neoplasms; imrt; tumors; radiotherapy, intensity-modulated; urinary bladder; radiation injuries; radiotherapy, conformal; antiandrogen; urogenital system; toxicity; computer assisted radiotherapy; rectum; dosimeters; urinary dysfunction; health risks; proctitis; dose escalation; rectum disease |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 70 |
| Issue: | 4 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2008-03-15 |
| Start Page: | 1124 |
| End Page: | 1129 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2007.11.044 |
| PUBMED: | 18313526 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 112" - "Export Date: 17 November 2011" - "CODEN: IOBPD" - "Source: Scopus" |
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