Hypofractionated Prostate Radiotherapy with or without Conventionally Fractionated Nodal Irradiation: Clinical Toxicity Observations and Retrospective Daily Dosimetry. (28th June 2012)

• Record Type: Journal Article
• Authors: McDonald, Andrew M.; Bishop, Justin M.; Jacob, Rojymon; Dobelbower, Michael C.; Kim, Robert Y.; Yang, Eddy S.; Smith, Heather; Wu, Xingen; Fiveash, John B.
• Other Names: Ben-Yosef Rami Academic Editor.
• Is Part Of: Prostate cancer. Volume 2012(2012)
• Publication Date: 2012-06-28
• Subjects: Prostate -- Cancer -- Periodicals; Prostate -- Cancer -- Surgery -- Periodicals; 616.99463
• DOI: 10.1155/2012/546794
• Languages: English
• ISSNs: 2090-3111

Abstract

Abstract : Purpose . To evaluate toxicity associated with the addition of elective nodal irradiation (ENI) to a hypofractionated regimen for the treatment of prostate cancer. Methods and Materials . Fifty-seven patients received pelvic image-guided IMRT to 50.4 Gy in 28 fractions with a hypofractionated simultaneous boost to the prostate to 70 Gy. Thirty-one patients received prostate-only treatment to 70 Gy in 28 fractions. Results . Median followup was 41.1 months. Early grade ≥2 urinary toxicity rates were 49% (28 of 57) for patients receiving ENI and 58% (18 of 31) for those not (P = 0.61 ). Early grade ≥2 rectal toxicity rates were 40% (23 of 57) and 23% (7 of 31), respectively (P = 0.09 ). The addition of ENI resulted in a 21% actuarial rate of late grade ≥2 rectal toxicity at 4 years, compared to 0% for patients treated to the prostate only (P = 0.02 ). Retrospective daily dosimetry of patients experiencing late rectal toxicity revealed an average increase of 2.67% of the rectal volume receiving 70 Gy compared to the original plan. Conclusions . The addition of ENI resulted in an increased risk of late rectal toxicity. Grade ≥2 late rectal toxicity was associated with worse daily rectal dosimetry compared to the treatment plan.