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RESEARCH PRODUCT
High-dose-rate brachytherapy boost for prostate cancer: Analysis of dose-volume histogram parameters for predicting late, rectal toxicity
Jose Perez-calatayudS. RoldanRodolfo Chicas-settVictoria Fornés-ferrerF. CeladaBlanca Ibanez-roselloD. FargaJose M. BenllochAlejandro TormoM.j. Pérez-calatayudsubject
MaleOrgans at RiskDose-volume histogramTime Factorsmedicine.medical_treatmentBrachytherapyBrachytherapyRectumLate rectal toxicity030218 nuclear medicine & medical imaging03 medical and health sciencesProstate cancerOrgan at risk0302 clinical medicinemedicineHumansRadiology Nuclear Medicine and imagingProspective StudiesExternal beam radiotherapyRadiation InjuriesAgedAged 80 and overProstate cancerbusiness.industryRadiotherapy Planning Computer-AssistedBiologically equivalent doseRectumProstatic NeoplasmsCommon Terminology Criteria for Adverse EventsMiddle Agedmedicine.diseaseCombined Modality TherapyHigh-Dose Rate BrachytherapyHigh-dose-rate brachytherapy boostRadiation therapyDose-volume histogram parametermedicine.anatomical_structureOncology030220 oncology & carcinogenesisRegression AnalysisDose Fractionation RadiationNuclear medicinebusinessFollow-Up Studiesdescription
PURPOSE: To determine the significance of dose-volume histogram parameters for predicting late rectal toxicity (LRT) after single-fraction high-dose-rate brachytherapy (HDRBT) boost and external beam radiotherapy (EBRT) in prostate cancer. MATERIALS AND METHODS: Three hundred patients with intermediate- or high-risk prostate cancer were included between August 2010 and March 2015. Treatment comprised a single-fraction HDRBT boost of 15.0 Gy plus EBRT (46.0 Gy delivered in 23 fractions) or an HDRBT boost of 9.5 Gy plus EBRT (60.0 Gy delivered in 30 fractions) if the seminal vesicles were infiltrated using real-time transrectal ultrasound-based planning. LRT was evaluated every 3 months after the end of the combined treatment using the Common Terminology Criteria for Adverse Events, version 4.0. The minimum dose received by the most exposed 0.1 and 2.0 cm(3) volume of the rectum (D0.1 cc/D2cc) was analyzed by estimating the biologically equivalent rectal dose according to the recommendations of the Groupe Europeen de Curietherapie/European Society for Radiotherapy and Oncology and an ordinal regression analysis was performed. RESULTS: LRT was observed in 62 patients (20.7%) at a median followup of 33 (range, 2-68) months. Twenty patients (6.7%) developed grade 2 and 3 patients (1%) developed grade 3 LRT. A significant association was observed between D2cc and the probability of developing grade 1-3 LRT (p = 0.04). CONCLUSIONS: D2cc is associated with the occurrence of LRT in HDRBT-treated prostate cancer patients. The dose constraints proposed and recommended by experienced HDRBT centers must be investigated to determine the threshold dose through long-term and prospective studies. (C) 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2017-05-01 |