International Journal of
Radiation Oncology biology
physics
www.redjournal.org
Clinical Investigation
Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients Ruud C. Wortel, MD,* Luca Incrocci, MD, PhD,* Floris J. Pos, MD, PhD,y Joos V. Lebesque, MD, PhD,y Marnix G. Witte, PhD,y Uulke A. van der Heide, PhD,y Marcel van Herk, PhD,y and Wilma D. Heemsbergen, PhDy *Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands; and yDepartment of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands Received Oct 1, 2014, and in revised form Dec 3, 2014. Accepted for publication Dec 8, 2014.
Summary Dose distributions to organs at risk and acute toxicity rates were compared between patients randomized to receive 78 Gy of imageguided intensity modulated radiation therapy (IG-IMRT; nZ260 patients) and those receiving 3-dimensional conformal radiation therapy (nZ215 patients). IG-IMRT resulted in significantly lower mean doses to anorectum, anal canal, and bladder. The incidences of the grade 2 endpoints proctitis, stool frequency 6/ day, urinary frequency 12/
Purpose: Image-guided intensity modulated radiation therapy (IG-IMRT) allows significant dose reductions to organs at risk in prostate cancer patients. However, clinical data identifying the benefits of IG-IMRT in daily practice are scarce. The purpose of this study was to compare dose distributions to organs at risk and acute gastrointestinal (GI) and genitourinary (GU) toxicity levels of patients treated to 78 Gy with either IG-IMRT or 3D-CRT. Methods and Materials: Patients treated with 3D-CRT (nZ215) and IG-IMRT (nZ260) receiving 78 Gy in 39 fractions within 2 randomized trials were selected. Dose surface histograms of anorectum, anal canal, and bladder were calculated. Identical toxicity questionnaires were distributed at baseline, prior to fraction 20 and 30 and at 90 days after treatment. Radiation Therapy Oncology Group (RTOG) grade 1, 2, and 3 endpoints were derived directly from questionnaires. Univariate and multivariate binary logistic regression analyses were applied. Results: The median volumes receiving 5 to 75 Gy were significantly lower (all P
Radiation Oncology biology
physics
www.redjournal.org
Clinical Investigation
Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients Ruud C. Wortel, MD,* Luca Incrocci, MD, PhD,* Floris J. Pos, MD, PhD,y Joos V. Lebesque, MD, PhD,y Marnix G. Witte, PhD,y Uulke A. van der Heide, PhD,y Marcel van Herk, PhD,y and Wilma D. Heemsbergen, PhDy *Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands; and yDepartment of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands Received Oct 1, 2014, and in revised form Dec 3, 2014. Accepted for publication Dec 8, 2014.
Summary Dose distributions to organs at risk and acute toxicity rates were compared between patients randomized to receive 78 Gy of imageguided intensity modulated radiation therapy (IG-IMRT; nZ260 patients) and those receiving 3-dimensional conformal radiation therapy (nZ215 patients). IG-IMRT resulted in significantly lower mean doses to anorectum, anal canal, and bladder. The incidences of the grade 2 endpoints proctitis, stool frequency 6/ day, urinary frequency 12/
Purpose: Image-guided intensity modulated radiation therapy (IG-IMRT) allows significant dose reductions to organs at risk in prostate cancer patients. However, clinical data identifying the benefits of IG-IMRT in daily practice are scarce. The purpose of this study was to compare dose distributions to organs at risk and acute gastrointestinal (GI) and genitourinary (GU) toxicity levels of patients treated to 78 Gy with either IG-IMRT or 3D-CRT. Methods and Materials: Patients treated with 3D-CRT (nZ215) and IG-IMRT (nZ260) receiving 78 Gy in 39 fractions within 2 randomized trials were selected. Dose surface histograms of anorectum, anal canal, and bladder were calculated. Identical toxicity questionnaires were distributed at baseline, prior to fraction 20 and 30 and at 90 days after treatment. Radiation Therapy Oncology Group (RTOG) grade 1, 2, and 3 endpoints were derived directly from questionnaires. Univariate and multivariate binary logistic regression analyses were applied. Results: The median volumes receiving 5 to 75 Gy were significantly lower (all P
