Acute toxicity of whole-pelvis IMRT in 87 patients with localized prostate cancer

Giuseppe Sanguineti, Eugene J. Endres, Brent Parker, Celine Bicquart, Michael Little, George Chen, Jason Berilgen

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Purpose. To assess the acute toxicity profile of whole pelvis IMRT (WP-IMRT) for localized prostate cancer. Materials. Eighty seven patients treated with definitive WP-IMRT at UTMB from May 2002 to November 2006 were retrospectively reviewed. Treatment consisted of two sequential phases, WP-IMRT to 54 Gy at 1.8 Gy per fraction to the pelvic nodes and seminal vesicles and 60 Gy at 2 Gy to the prostate, and a separate external beam boost, 3DCRT or IMRT, to bring the dose to the prostate to 76 Gy. Acute toxicity was prospectively scored weekly during treatment and at 3 month follow-up according to CTC v2.0 for 10 genitourinary (GU) and gastrointestinal (GI) domains. The proportion of patients experiencing a given level of peak acute toxicity at a given point is reported. Results. Treatment was feasible with delivered doses to PTVs not significantly lower than planned ones and with only two patients experiencing treatment gaps longer than 5 days. About 2/3 and 1/10 of the patients experienced peak grade 2 and grade 3 reactions at least once during RT, respectively. Frequency/urgency (Grade 2+: 37.9%) and diarrhea (36.7%) were the most prevalent symptoms followed by proctitis (21.8%) and dysuria (16.1%). GI reactions were generally shorter lasting compared to GU ones which accumulated progressively during treatment. At 3 months, almost half of the patients were asymptomatic and most of observed reactions (89.2%) were mild, with GI ones more likely to be fully resolved (92.5%) than GU ones (68.7%, χ2, p=0.001). Conclusion. Our approach is dosimetrically and clinically feasible with intense, but transient, acute toxicity.

Original languageEnglish (US)
Pages (from-to)301-310
Number of pages10
JournalActa Oncologica
Volume47
Issue number2
DOIs
StatePublished - 2008

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Pelvis
Prostatic Neoplasms
Prostate
Proctitis
Therapeutics
Dysuria
Seminal Vesicles
Diarrhea

ASJC Scopus subject areas

  • Oncology

Cite this

Sanguineti, G., Endres, E. J., Parker, B., Bicquart, C., Little, M., Chen, G., & Berilgen, J. (2008). Acute toxicity of whole-pelvis IMRT in 87 patients with localized prostate cancer. Acta Oncologica, 47(2), 301-310. https://doi.org/10.1080/02841860701558849

Acute toxicity of whole-pelvis IMRT in 87 patients with localized prostate cancer. / Sanguineti, Giuseppe; Endres, Eugene J.; Parker, Brent; Bicquart, Celine; Little, Michael; Chen, George; Berilgen, Jason.

In: Acta Oncologica, Vol. 47, No. 2, 2008, p. 301-310.

Research output: Contribution to journalArticle

Sanguineti, G, Endres, EJ, Parker, B, Bicquart, C, Little, M, Chen, G & Berilgen, J 2008, 'Acute toxicity of whole-pelvis IMRT in 87 patients with localized prostate cancer', Acta Oncologica, vol. 47, no. 2, pp. 301-310. https://doi.org/10.1080/02841860701558849
Sanguineti, Giuseppe ; Endres, Eugene J. ; Parker, Brent ; Bicquart, Celine ; Little, Michael ; Chen, George ; Berilgen, Jason. / Acute toxicity of whole-pelvis IMRT in 87 patients with localized prostate cancer. In: Acta Oncologica. 2008 ; Vol. 47, No. 2. pp. 301-310.
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abstract = "Purpose. To assess the acute toxicity profile of whole pelvis IMRT (WP-IMRT) for localized prostate cancer. Materials. Eighty seven patients treated with definitive WP-IMRT at UTMB from May 2002 to November 2006 were retrospectively reviewed. Treatment consisted of two sequential phases, WP-IMRT to 54 Gy at 1.8 Gy per fraction to the pelvic nodes and seminal vesicles and 60 Gy at 2 Gy to the prostate, and a separate external beam boost, 3DCRT or IMRT, to bring the dose to the prostate to 76 Gy. Acute toxicity was prospectively scored weekly during treatment and at 3 month follow-up according to CTC v2.0 for 10 genitourinary (GU) and gastrointestinal (GI) domains. The proportion of patients experiencing a given level of peak acute toxicity at a given point is reported. Results. Treatment was feasible with delivered doses to PTVs not significantly lower than planned ones and with only two patients experiencing treatment gaps longer than 5 days. About 2/3 and 1/10 of the patients experienced peak grade 2 and grade 3 reactions at least once during RT, respectively. Frequency/urgency (Grade 2+: 37.9{\%}) and diarrhea (36.7{\%}) were the most prevalent symptoms followed by proctitis (21.8{\%}) and dysuria (16.1{\%}). GI reactions were generally shorter lasting compared to GU ones which accumulated progressively during treatment. At 3 months, almost half of the patients were asymptomatic and most of observed reactions (89.2{\%}) were mild, with GI ones more likely to be fully resolved (92.5{\%}) than GU ones (68.7{\%}, χ2, p=0.001). Conclusion. Our approach is dosimetrically and clinically feasible with intense, but transient, acute toxicity.",
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