Radiotherapy & Oncology
Volume 93, Issue 2 , Pages 207-212 , November 2009

IMRT significantly reduces acute toxicity of whole-pelvis irradiation in patients treated with post-operative adjuvant or salvage radiotherapy after radical prostatectomy

  • Filippo Alongi

      Affiliations

    • Department of Radiotherapy, Scientific Institute H San Raffaele, Milan, Italy
    • I.B.F.M National Research Council (CNR), Italy
    • L.A.T.O. HSR-G. Giglio, Cefalù, Italy
    • Corresponding Author InformationCorresponding author. Address: Department of Radiotherapy, Scientific Institute H San Raffaele, Via Olgettina 60, Milan, Italy.
    • ,
  • Claudio Fiorino

      Affiliations

    • Department of Medical Physics, Scientific Institute H San Raffaele, Milan, Italy
    • ,
  • Cesare Cozzarini

      Affiliations

    • Department of Radiotherapy, Scientific Institute H San Raffaele, Milan, Italy
    • ,
  • Sara Broggi

      Affiliations

    • Department of Medical Physics, Scientific Institute H San Raffaele, Milan, Italy
    • ,
  • Lucia Perna

      Affiliations

    • Department of Medical Physics, Scientific Institute H San Raffaele, Milan, Italy
    • ,
  • Giovanni Mauro Cattaneo

      Affiliations

    • Department of Medical Physics, Scientific Institute H San Raffaele, Milan, Italy
    • ,
  • Riccardo Calandrino

      Affiliations

    • Department of Medical Physics, Scientific Institute H San Raffaele, Milan, Italy
    • ,
  • Nadia Di Muzio

      Affiliations

    • Department of Radiotherapy, Scientific Institute H San Raffaele, Milan, Italy

Received 17 December 2008 ,Revised 26 August 2009 ,Accepted 27 August 2009.

References 

  1. Roach M, DeSilvio C, Lawton CA, et al. Phase III trial comparing whole-pelvic versus prostate-only radiotherapy and neo-adjuvant versus adjuvant combined androgen suppression: Radiation Therapy Oncology Group 9413. J Clin Oncol. 2003;21:1904–1911
  2. Spiotto MT, Hancock SL, King CR. Radiotherapy after prostatectomy: improved biochemical relapse-free survival with whole pelvic compared with prostate bed only for high-risk patients. Int J Radiat Oncol Biol Phys. 2007;69:54–61
  3. Partin AW, Kattan MW, Subong EN, et al. Combination of prostate specific antigen, clinical stage and Gleason score to predict pathological stage in men with localized prostate cancer. A multi-institutional update. J Am Med Assoc. 1997;277:1445–1451
  4. Roach M, Marquez C, You H, et al. Predicting the risk of lymph node involvement using the pre-treatment prostate specific antigen and Gleason score in men with clinically localised prostate cancer. Int J Radiat Oncol Biol Phys. 1993;28:33–37
  5. Stone NN, Stock RG, Unger P. Laparoscopic pelvic lymph node dissection for prostate cancer: comparison of the extended and modified techniques. J Urol. 1997;158:18–94
  6. Heidenreich A, Varga Z, Von Knobloch R. Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: high incidence of lymph node metastasis. J Urol. 2002;167:1681–1686
  7. Wagner M. The role of pelvic lymphadenectomy for prostate cancer: therapeutic?. J Urol. 2008;179:408–413
  8. Herold DM, Hanlon AL, Hanks GE. Diabetes mellitus: a predictor for late radiation morbidity. Int J Radiat Oncol Biol Phys. 1999;43:475–479
  9. Skwarchuk MW, Jackson A, Zelefsky MJ, et al. Late rectal toxicity after conformal radiotherapy of prostate cancer (I): multivariate analysis and dose–response. Int J Radiat Oncol Biol Phys. 2000;47:103–113
  10. Fiorino C, Alongi F, Broggi S, et al. Physics aspects of prostate tomotherapy: planning optimization and image-guidance issues. Acta Oncol. 2008;47:1309–1316
  11. Cozzarini C, Bolognesi A, Ceresoli GL, et al. Role of post-operative radiotherapy after pelvic lymphadenectomy and radical retropubic prostatectomy: a single institute experience of 415 patients. Int J Radiat Oncol Biol Phys. 2004;59:674–683
  12. Poortmans P, Bossi A, Vandeputte K, et al. Guidelines for target volume definition in post-operative radiotherapy for prostate cancer, on behalf of the EORTC Radiation Oncology Group. Radiother Oncol. 2007;84:121–127
  13. Martinez-Monge R, Fernandes PS, Gupta N, Gahbauer R. Cross-sectional nodal atlas: a tool for the definition of clinical target volumes in three-dimensional radiation therapy planning. Radiology. 1999;211:815–828
  14. Fokdal L, Honore H, Hoyer M, Von der M. Dose–volume histograms associated to long-term colorectal functions in patients receiving pelvic radiotherapy. Radiother Oncol. 2005;74:203–210
  15. Hysing LB, Kvinnsland Y, Lord H, Muren LP. Planning organ at risk volume margins for organ motion of the intestine. Radiother Oncol. 2006;80:349–354
  16. Sanguineti G, Little M, Endres EJ, et al. Comparison of three strategies to delineate the bowel for whole-pelvis IMRT of prostate cancer. Radiother Oncol. 2008;88:95–101
  17. Kvinnsland Y, Muren LP. The impact of organ motion on intestine doses and complication probabilities in radiotherapy of bladder cancer. Radiother Oncol. 2005;76:43–47
  18. Hysing LB, Skorpen TN, Alber M, et al. Influence of organ motion of conformal vs. intensity-modulated pelvic radiotherapy of prostate cancer. Int J Radiat Oncol Biol Phys. 2008;71:1496–1503
  19. Fiorino C, Alongi F, Perna L, et al. Dose–volume relationships for acute bowel toxicity for patients treated with pelvic nodal irradiation for prostate cancer. Int J Radiat Oncol Biol Phys. 2009;75:29–35
  20. Cavey ML, Bayouth JE, Colman M, et al. IMRT to escalate the dose to the prostate while treating the pelvic nodes. Strahlenther Onkol. 2005;181:431–441
  21. Price RAJ, Hannoun-Levi JM, Horwitz E, et al. Impact of pelvic nodal irradiation with intensity-modulated radiotherapy on treatment of prostate cancer. Int J Radiat Oncol Biol Phys. 2006;66:583–592
  22. Sanguineti G, Cavey ML, Endres EJ, et al. Does treatment of the pelvic nodes with IMRT increase late rectal toxicity over conformal prostate-only radiotherapy to 76Gy?. Strahlenther Onkol. 2006;182:543–549
  23. Fiorino C, Sanguineti G, Cozzarini C, et al. Dose–volume constraints in high-dose radiotherapy of localized prostate cancer. Int J Radiat Oncol Biol Phys. 2003;57:953–962
  24. Rancati T, Fiorino C, Gagliardi G, et al. Fitting late rectal bleeding data using different NTCP models: results from an Italian multi-centric study (AIROPROS0101). Radiother Oncol. 2004;73:21–32
  25. Fiorino C, Cozzarini C, Vavassori V, et al. Relationships between DVHs and late rectal bleeding after radiotherapy for prostate cancer: analysis of a large group of patients pooled from three institutions. Radiother Oncol. 2002;64:1–12
  26. Bolla M, van Poppel H, Collette L. Post-operative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet. 2005;366:572–578
  27. Thompson IM, Tangen CM, Paradelo J, et al. Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial. JAMA. 2006;296:2329–2335
  28. Morgan SC, Waldron TS, Eapen L, et al. Adjuvant radiotherapy following radical prostatectomy for pathologic T3 or margin-positive prostate cancer: a systematic review and meta-analysis. Radiother Oncol. 2008;88:1–9
  29. Cozzarini C, Fiorino C, Di Muzio N, et al. Significant reduction of acute toxicity following pelvic irradiation with helical tomotherapy in patients with localized prostate cancer. Radiother Oncol. 2007;8:164–170
  30. Arcangeli S, Saracino B, Petrongari MG, et al. Analysis of toxicity in patients with high-risk prostate cancer treated with intensity-modulated pelvic radiation therapy and simultaneous integrated dose escalation to prostate area. Radiother Oncol. 2007;84:148–155
  31. Di Muzio N, Fiorino C, Cozzarini C, et al. Phase I–II study of hipofractionated simultaneous integrated boost with tomotherapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2009;1:392–398
  32. Sanguineti G, Endres EJ, Parker BC, et al. Acute toxicity of whole-pelvis IMRT in 87 patients with localized prostate cancer. Acta Oncol. 2008;47:301–310
  33. Pasquier D, Ballereau C. Adjuvant and salvage radiotherapy after prostatectomy for prostate cancer: a literature review. Int J Radiat Oncol Biol Phys. 2008;72:972–979
  34. Jereczek-Fossa BA, Zerini D, Vavassori A, et al. Sooner or later? Outcome analysis of 431 prostate cancer patients treated with post-operative or salvage radiotherapy. Int J Radiat Oncol Biol Phys. 2009;74:115–125
  35. Van Der Poel HG, Moonen L, Horenblas S. Sequential treatment for recurrent localized prostate cancer. J Surg Oncol. 2008;97:377–382
  36. Eulau SM, Tate DJ, Stamey TA, Bagshaw MA, Hancock SL. Effect of combined transient androgen deprivation and irradiation following radical prostatectomy for prostatic cancer. Int J Radiat Oncol Biol Phys. 1998;41:735–740
  37. King CR, Presti JCJ, Gill H, Brooks J, Hancock SL. Radiotherapy after radical prostatectomy: does transient androgen suppression improve outcomes?. Int J Radiat Oncol Biol Phys. 2004;59:341–347
  38. Peeters ST, Hoogeman MS, Heemsbergen WD, et al. Volume and hormonal effects for acute side effects of rectum and bladder during conformal radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2005;15:1142–1152
  39. King CR, Kapp DS. Radiotherapy after prostatectomy: is the evidence for dose escalation out there?. Int J Radiat Oncol Biol Phys. 2008;71:346–350
  40. Cozzarini C, Montorsi F, Fiorino C, et al. The need for high radiation doses (⩾70Gy) even in early post-operative irradiation after radical prostatectomy. A mono-institutional analysis on 334 high-risk, node-negative patients. Int J Radiat Oncol Biol Phys 2009; doi:10.1016/j.ijrobp.2008.12.059.

PII: S0167-8140(09)00494-0

doi: 10.1016/j.radonc.2009.08.042

Radiotherapy & Oncology
Volume 93, Issue 2 , Pages 207-212 , November 2009

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