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COMPARISON OF ACUTE TOXICITY BETWEEN MODERATE HYPOFRACTIONATION WITH VOLUMETRIC MODULATION ARC THERAPY AND CONVENTIONAL FRACTIONATION WITH THREE DIMENSIONAL CONFORMAL RADIATION THERAPY IN POSTOPERATIVE PROSTATE CANCER PATIENTS

Anticancer research, 2013-05, Vol.33 (5), p.2259-2260 [Peer Reviewed Journal]

ISSN: 0250-7005 ;EISSN: 1791-7530

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  • Title:
    COMPARISON OF ACUTE TOXICITY BETWEEN MODERATE HYPOFRACTIONATION WITH VOLUMETRIC MODULATION ARC THERAPY AND CONVENTIONAL FRACTIONATION WITH THREE DIMENSIONAL CONFORMAL RADIATION THERAPY IN POSTOPERATIVE PROSTATE CANCER PATIENTS
  • Author: Alongi, F ; Iftode, C ; Comito, T ; Villa, E ; Liardo, RLE ; Tozzi, A ; Mancosu, P ; Tomatis, S ; Fogliata, A ; Cozzi, L ; Taverna, G ; Graziotti, P ; Scorsetti, M
  • Subjects: Acute toxicity
  • Is Part Of: Anticancer research, 2013-05, Vol.33 (5), p.2259-2260
  • Description: Objectives: To retrospectively evaluate and compare the incidence of acute genito-urinary(GU), upper gastrointestinal (uGI) and rectal (1GI injuries of hypofractionation by volumetric modulation arc therapy (Hypo-RapidArc group) and conventional fractionation by three dimensional conformal radiotherapy(3DCRT group) in patients with localized prostate cancer treated with prostatic bed irradiation, after radical prostatectomy. Patients and Methods: Between 2007 and 2012, 84 consecutive patients with clinically localized prostate, submitted to radical prostatectomy, were also irradiated to prostate bed in our Institute, of the 84 patients 41 had undergone 3DCRT and 43 patients were treated with RapidArc (after its clinical use for prostate bed in 2009/2010). The median age was 67 and 68.5 years for 3DCRT and HypoRapidArc group respectively. The median dose to the prostatic bed was 70 Gy (70-76) with 2 Gy per fraction in 3DCRT group and 70 Gy (70-72.4) with 2.5Gy (2.5-2.55) per fraction in the Hypo-RapidArc group. After radical prostatectomy, the median time to RT was 15 and 16 months respectively in 3DCRT and Hypo-RapidArc group. Acute GU, uGI e 1GI toxicities after radiation treatment were evaluated using Radiation Therapy and Oncology Group/European Onganization for Research and Treatment of Cancer (RTOG/EORTC) medical scoring system. Results: Acute GU G2 was recorded in 17% of cases in 3DRCT group and in 12% in Hypo-RapidArc group. No acute G2 uGI toxicities were found in 3DCRT versus 7% in Hypo-RapidArc group. Regarding 1GI G2 toxicities were 7% in 3DCRT versus 18% in Hypo-RapidArc group. No G3 or greater toxicities was found in both groups. In both groups the PTV coverage was suitable: PTV mean dose was 99.4 plus or minus 1.0% and 99.8 plus or minus 0.9% and V95% 96.3 plus or minus 3.6% and 95.7 plus or minus 8.9 for 3DRCT and RA group respectively. For 3DRTC group the rectum received a mean dose of 42.1 plus or minus 9.4 Gy (with V65Gy equal to 26.9 plus or minus 10.0%) and the bladder received 69.3 plus or minus 17.2 Gy in mean (with the V65Gy equal to 45.0+19.5%); and for RA group the dose decreased to 37.2 plus or minus 5.2 Gy (V65Gy 9.6 plus or minus 5.1%) and 39.2 plus or minus 13.4 (V65Gy 25.2 plus or minus 14.4%) for rectum and bladder. Conclusion: The results of our study of 84 patients have shown that acute G2 GU are reduced using hypofractionation by RapidArc compared to conventional fractionation by 3DCRT, while acute G2 GI toxicities remain better for the last one. Remarkable is the absence of G3 using hypofractionation by RapidArc as well as recorded previously with conventional fractionation by 3DCRT. Longer term data are awaited for late toxicity profiles and clinical efficacy in HypoRapidArc group of patients.
  • Language: English
  • Identifier: ISSN: 0250-7005
    EISSN: 1791-7530
  • Source: Alma/SFX Local Collection
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