Acute toxicity of curative radiotherapy for intermediate- and high-risk localised prostate cancer in the EORTC trial 22991.

Details

Serval ID
serval:BIB_D6B21F03E134
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Acute toxicity of curative radiotherapy for intermediate- and high-risk localised prostate cancer in the EORTC trial 22991.
Journal
European Journal of Cancer
Author(s)
Matzinger O., Duclos F., van den Bergh A., Carrie C., Villà S., Kitsios P., Poortmans P., Sundar S., van der Steen-Banasik E.M., Gulyban A., Collette L., Bolla M.
ISSN
1879-0852[electronic]
Publication state
Published
Issued date
2009
Volume
45
Number
16
Pages
2825-2834
Language
english
Abstract
INTRODUCTION: This trial randomly assessed short-term adjuvant hormonal therapy added to radiotherapy (RT) for intermediate- and high-risk (UICC 1997 cT2a or cT1b-c with high PSA or Gleason score) localised prostate cancer. We report acute toxicity (CTCAE v2) assessed weekly during RT in relation to radiation parameters. PATIENTS AND METHODS: Centres selected the RT dose (70, 74 or 78Gy) and RT technique. Statistical significance is at 0.05. RESULTS: Of 791 patients, 652 received 3D-CRT (70Gy: 195, 74Gy: 376, 78Gy: 81) and 139 received IMRT (74Gy: 28, 78Gy: 111). During RT, grade 3 gastrointestinal (GI) and genitourinary (GU) toxicities were reported by 7 (0.8%) and 50 (6.3%) patients, respectively. No grade 4 was reported. The risk of grade 2 GI toxicity increased significantly with increasing D50%-rectum (p=0.004) and that of grade 2 GU toxicity correlated only to Dmax-bladder (p=0.051). 3D-RT technique, increasing total dose and V95% >400 cc increased D50% and Dmax. One month after RT, only 14 patients (1.8%) reported grade 3 toxicity. AST did not seem to influence the risk of GU or GI acute toxicity. CONCLUSION: RT up to 78Gy was well tolerated. Dmax-bladder and D50%-rectum influenced the risk of grade 2 GU toxicity and GI toxicity, respectively. Both were lower with IMRT but remained high for an irradiated RT volume>400 cc for 3D-RT and for a dose of 78Gy. Hormonal treatment did not influence acute toxicity.
Keywords
Quality assurance, Acute toxicity, Radiotherapy, Prostate cancer, Randomised trial, Intensity-Modulated Radiotherapy, Conformal Radiotherapy, Randomized-Trial, Dose-Escalation, Gastrointestinal Toxicity, Radiation-Therapy, GY
Pubmed
Web of science
Create date
15/12/2009 16:30
Last modification date
20/08/2019 15:56
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