Comparison of genitourinary and gastrointestinal toxicity among four radiotherapy modalities for prostate cancer: Conventional radiotherapy, intensity-modulated radiotherapy, and permanent iodine-125 implantation with or without external beam radiotherapy

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Shinya SutaniNaoyuki Shigematsu

Abstract

To compare late genitourinary (GU) and gastrointestinal (GI) toxicity following different prostate cancer treatment modalities. This study included 1084 consecutive prostate cancer patients treated with conventional radiotherapy, intensity-modulated radiotherapy (IMRT), permanent iodine-125 implantation (PI) alone, and PI combined with external beam radiotherapy (PI+EBRT). The effects of treatment- and patient-related factors on late grade ⩾ 2 (G2+) GU/GI toxicity risk were assessed. The median follow-up was 43 months (range, 12-97 months). Compared to the PI+EBRT, there was significantly less G2+ GU toxicity in the conventional radiotherapy (hazard ratio [HR] = 0.39; 95% CI, 0.20-0.77) and the IMRT (HR=0.45, 95% CI, 0.27-0.73). Compared to the PI+EBRT, there was significantly more G2+ GI toxicity in the IMRT (HR = 2.38; 95% CI, 1.16-4.87). In PI-related groups, prostate equivalent dose in 2 Gy fractions was a significant predictor of G2+ GU toxicity (p = 0.001), and the rectal volume receiving more than 100% of the prescribed dose was a significant predictor of G2+ GI toxicity (p = 0.001). The differences in the late G2+ GU/GI risk cannot be explained by the differences in treatment modalities themselves, but by the total radi...Continue Reading

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Citations

Jan 23, 2016·Advances in Urology·C BrowneD J Galvin
Jul 3, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Noorazrul YahyaJames W Denham
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Dec 23, 2017·Reports of Practical Oncology and Radiotherapy : Journal of Greatpoland Cancer Center in Poznań and Polish Society of Radiation Oncology·Hidekazu TanakaMasayuki Matsuo

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