Acute toxicity of three-dimensional conformal radiotherapy in prostate cancer patients eligible for implant monotherapy

Rachel H. Chou, Richard B. Wilder, Ming Ji, Janice K. Ryu, Bryan R. Leigh, John D. Earle, R. L Scotte Doggett, H. Dale Kubo, Mack Roach, Ralph W deVere White

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Abstract

Purpose: To assess the acute toxicity of three-dimensional conformal radiotherapy (3D-CRT) in prostate cancer patients eligible for implant monotherapy.Methods and Materials: Between December 1991 and June 1998, 198 prostate cancer patients were treated with 3D-CRT at the University of California Davis Medical Center. Fifty-two of these patients had a prostate-specific antigen (PSA) level ≤ 10.0 ng/ml, Gleason score ≤ 6, and a 1997 AJCC clinical stage T1bN0-T2bN0. Eleven (21%) patients received radiotherapy to the prostate and seminal vesicles; the remaining patients were treated to the prostate only. The 3D-CRT treatment planning guidelines in Radiation Therapy Oncology Group (RTOG) 9406 were followed after 1994 (similar treatment planning was used before the protocol became available). Typically, 4 oblique and 2 lateral fields were treated. All patients were seen at least weekly while under treatment, 1 month postirradiation and then every 3 months. Total radiation doses ranged from 66.0-79.2 Gy, with a median dose of 73.8 Gy in 41 fractions over 8 weeks. Acute toxicity is described according to the RTOG acute toxicity scoring system.Results: Overall, 3D-CRT was well-tolerated: 29% of patients experienced RTOG Grade 1 and 27% experienced Grade 2 acute lower gastrointestinal (GI) toxicity. Forty percent and 33% of patients experienced Grade 1 and 2 acute genitourinary (GU) toxicity, respectively. As expected, more acute morbidity, especially GI, was observed with a larger clinical target volume (prostate and seminal vesicles versus prostate only; p = 0.05). Neoadjuvant hormonal therapy did not increase the incidence or severity of radiation-induced side effects. No acute toxicity ≥ Grade 3, e.g., hourly nocturia, gross hematuria, diarrhea requiring parenteral support, narcotics for pain control, or catheterization for acute urinary retention, was observed.Conclusion: Although relatively high doses of radiation are delivered to prostate cancers with 3D-CRT compared with conventional radiotherapy, 3D-CRT is surprisingly well-tolerated. No patients in the cohort eligible for implant monotherapy experienced acute toxicity ≥ Grade 3. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)115-119
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Volume47
Issue number1
DOIs
StatePublished - Apr 1 2000

Fingerprint

Conformal Radiotherapy
toxicity
radiation therapy
Prostatic Neoplasms
cancer
grade
Radiotherapy
Radiation Oncology
Prostate
Seminal Vesicles
Radiation
dosage
planning
hematuria
radiation
narcotics
catheterization
Nocturia
Neoadjuvant Therapy
Urinary Retention

Keywords

  • Acute toxicity
  • Prostate cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Acute toxicity of three-dimensional conformal radiotherapy in prostate cancer patients eligible for implant monotherapy. / Chou, Rachel H.; Wilder, Richard B.; Ji, Ming; Ryu, Janice K.; Leigh, Bryan R.; Earle, John D.; Doggett, R. L Scotte; Kubo, H. Dale; Roach, Mack; deVere White, Ralph W.

In: International Journal of Radiation Oncology Biology Physics, Vol. 47, No. 1, 01.04.2000, p. 115-119.

Research output: Contribution to journalArticle

Chou, Rachel H. ; Wilder, Richard B. ; Ji, Ming ; Ryu, Janice K. ; Leigh, Bryan R. ; Earle, John D. ; Doggett, R. L Scotte ; Kubo, H. Dale ; Roach, Mack ; deVere White, Ralph W. / Acute toxicity of three-dimensional conformal radiotherapy in prostate cancer patients eligible for implant monotherapy. In: International Journal of Radiation Oncology Biology Physics. 2000 ; Vol. 47, No. 1. pp. 115-119.
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abstract = "Purpose: To assess the acute toxicity of three-dimensional conformal radiotherapy (3D-CRT) in prostate cancer patients eligible for implant monotherapy.Methods and Materials: Between December 1991 and June 1998, 198 prostate cancer patients were treated with 3D-CRT at the University of California Davis Medical Center. Fifty-two of these patients had a prostate-specific antigen (PSA) level ≤ 10.0 ng/ml, Gleason score ≤ 6, and a 1997 AJCC clinical stage T1bN0-T2bN0. Eleven (21{\%}) patients received radiotherapy to the prostate and seminal vesicles; the remaining patients were treated to the prostate only. The 3D-CRT treatment planning guidelines in Radiation Therapy Oncology Group (RTOG) 9406 were followed after 1994 (similar treatment planning was used before the protocol became available). Typically, 4 oblique and 2 lateral fields were treated. All patients were seen at least weekly while under treatment, 1 month postirradiation and then every 3 months. Total radiation doses ranged from 66.0-79.2 Gy, with a median dose of 73.8 Gy in 41 fractions over 8 weeks. Acute toxicity is described according to the RTOG acute toxicity scoring system.Results: Overall, 3D-CRT was well-tolerated: 29{\%} of patients experienced RTOG Grade 1 and 27{\%} experienced Grade 2 acute lower gastrointestinal (GI) toxicity. Forty percent and 33{\%} of patients experienced Grade 1 and 2 acute genitourinary (GU) toxicity, respectively. As expected, more acute morbidity, especially GI, was observed with a larger clinical target volume (prostate and seminal vesicles versus prostate only; p = 0.05). Neoadjuvant hormonal therapy did not increase the incidence or severity of radiation-induced side effects. No acute toxicity ≥ Grade 3, e.g., hourly nocturia, gross hematuria, diarrhea requiring parenteral support, narcotics for pain control, or catheterization for acute urinary retention, was observed.Conclusion: Although relatively high doses of radiation are delivered to prostate cancers with 3D-CRT compared with conventional radiotherapy, 3D-CRT is surprisingly well-tolerated. No patients in the cohort eligible for implant monotherapy experienced acute toxicity ≥ Grade 3. Copyright (C) 2000 Elsevier Science Inc.",
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AU - Leigh, Bryan R.

AU - Earle, John D.

AU - Doggett, R. L Scotte

AU - Kubo, H. Dale

AU - Roach, Mack

AU - deVere White, Ralph W

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N2 - Purpose: To assess the acute toxicity of three-dimensional conformal radiotherapy (3D-CRT) in prostate cancer patients eligible for implant monotherapy.Methods and Materials: Between December 1991 and June 1998, 198 prostate cancer patients were treated with 3D-CRT at the University of California Davis Medical Center. Fifty-two of these patients had a prostate-specific antigen (PSA) level ≤ 10.0 ng/ml, Gleason score ≤ 6, and a 1997 AJCC clinical stage T1bN0-T2bN0. Eleven (21%) patients received radiotherapy to the prostate and seminal vesicles; the remaining patients were treated to the prostate only. The 3D-CRT treatment planning guidelines in Radiation Therapy Oncology Group (RTOG) 9406 were followed after 1994 (similar treatment planning was used before the protocol became available). Typically, 4 oblique and 2 lateral fields were treated. All patients were seen at least weekly while under treatment, 1 month postirradiation and then every 3 months. Total radiation doses ranged from 66.0-79.2 Gy, with a median dose of 73.8 Gy in 41 fractions over 8 weeks. Acute toxicity is described according to the RTOG acute toxicity scoring system.Results: Overall, 3D-CRT was well-tolerated: 29% of patients experienced RTOG Grade 1 and 27% experienced Grade 2 acute lower gastrointestinal (GI) toxicity. Forty percent and 33% of patients experienced Grade 1 and 2 acute genitourinary (GU) toxicity, respectively. As expected, more acute morbidity, especially GI, was observed with a larger clinical target volume (prostate and seminal vesicles versus prostate only; p = 0.05). Neoadjuvant hormonal therapy did not increase the incidence or severity of radiation-induced side effects. No acute toxicity ≥ Grade 3, e.g., hourly nocturia, gross hematuria, diarrhea requiring parenteral support, narcotics for pain control, or catheterization for acute urinary retention, was observed.Conclusion: Although relatively high doses of radiation are delivered to prostate cancers with 3D-CRT compared with conventional radiotherapy, 3D-CRT is surprisingly well-tolerated. No patients in the cohort eligible for implant monotherapy experienced acute toxicity ≥ Grade 3. Copyright (C) 2000 Elsevier Science Inc.

AB - Purpose: To assess the acute toxicity of three-dimensional conformal radiotherapy (3D-CRT) in prostate cancer patients eligible for implant monotherapy.Methods and Materials: Between December 1991 and June 1998, 198 prostate cancer patients were treated with 3D-CRT at the University of California Davis Medical Center. Fifty-two of these patients had a prostate-specific antigen (PSA) level ≤ 10.0 ng/ml, Gleason score ≤ 6, and a 1997 AJCC clinical stage T1bN0-T2bN0. Eleven (21%) patients received radiotherapy to the prostate and seminal vesicles; the remaining patients were treated to the prostate only. The 3D-CRT treatment planning guidelines in Radiation Therapy Oncology Group (RTOG) 9406 were followed after 1994 (similar treatment planning was used before the protocol became available). Typically, 4 oblique and 2 lateral fields were treated. All patients were seen at least weekly while under treatment, 1 month postirradiation and then every 3 months. Total radiation doses ranged from 66.0-79.2 Gy, with a median dose of 73.8 Gy in 41 fractions over 8 weeks. Acute toxicity is described according to the RTOG acute toxicity scoring system.Results: Overall, 3D-CRT was well-tolerated: 29% of patients experienced RTOG Grade 1 and 27% experienced Grade 2 acute lower gastrointestinal (GI) toxicity. Forty percent and 33% of patients experienced Grade 1 and 2 acute genitourinary (GU) toxicity, respectively. As expected, more acute morbidity, especially GI, was observed with a larger clinical target volume (prostate and seminal vesicles versus prostate only; p = 0.05). Neoadjuvant hormonal therapy did not increase the incidence or severity of radiation-induced side effects. No acute toxicity ≥ Grade 3, e.g., hourly nocturia, gross hematuria, diarrhea requiring parenteral support, narcotics for pain control, or catheterization for acute urinary retention, was observed.Conclusion: Although relatively high doses of radiation are delivered to prostate cancers with 3D-CRT compared with conventional radiotherapy, 3D-CRT is surprisingly well-tolerated. No patients in the cohort eligible for implant monotherapy experienced acute toxicity ≥ Grade 3. Copyright (C) 2000 Elsevier Science Inc.

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