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The impact of prostate gland dimension in genitourinary toxicity after definitive prostate cancer treatment with moderate hypofractionation and volumetric modulated arc radiation therapy

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Abstract

Purpose

To analyze clinical-dosimetric predictors of genitourinary (GU) toxicity in a cohort of prostate cancer (PC) patients treated with moderate hypofractionation and simultaneous integrated boost (SIB) using volumetric modulated arc therapy (VMAT) technique.

Materials and methods

60 patients were selected. Patients were stratified into low (43 %), intermediate (30 %) and high-risk (27 %) groups. Low-risk patients received 73.5 Gy to PTV1; intermediate-risk received 73.5 Gy to PTV1 and 60 Gy to PTV2; high-risk received 73.5 Gy to PTV1, 60 Gy to PTV2, and 54 Gy to PTV3. All patients were treated in 30 fractions. Androgen deprivation therapy (ADT) was prescribed upfront in intermediate and high-risk categories. Toxicity was scored according to Common Terminology Criteria for Adverse Events v4.0 scoring system.

Results

Median follow-up was 30 months (range 16–36 months). GU acute toxicity was recorded as followS: G0 = 16/60 (27 %), G1 = 18/60 (30 %); G2 = 26/60 (43 %). GU late toxicity was recorded as follows: G0 = 20/60 (34 %); G1 = 29/60 (48 %); G2 = 11/56 (18 %). The risk of acute G2 GU toxicity was three times higher for prostate volume ≥80 cc. In 60 % of the patients with a prostate volume ≥80 cc, the first 3 weeks are at particular risk for toxicity onset. In the late setting, no statistical significance was found between GU toxicity and prostate gland dimension.

Conclusion

Prostate volume ≥80 cc resulted a predictive factor of acute G2 GU toxicity, in moderate hypofractionation and volumetric modulated arc radiation therapy for definitive PC.

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Acknowledgments

The current study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.

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Authors and Affiliations

  1. Radiation Oncology, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy

    R. Mazzola, S. Fersino, A. Fiorentino, F. Ricchetti, N. Giaj Levra, G. Sicignano, S. Naccarato, R. Ruggieri & F. Alongi

  2. Radiation Oncology School, University of Palermo, Palermo, Italy

    R. Mazzola

  3. Statistic Sciences Faculty, University of Palermo, Palermo, Italy

    G. Di Paola

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  1. R. Mazzola
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  2. S. Fersino
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  3. A. Fiorentino
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  5. N. Giaj Levra
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Correspondence to A. Fiorentino.

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The authors declare that they have no conflict of interest. The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

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Mazzola, R., Fersino, S., Fiorentino, A. et al. The impact of prostate gland dimension in genitourinary toxicity after definitive prostate cancer treatment with moderate hypofractionation and volumetric modulated arc radiation therapy. Clin Transl Oncol 18, 317–321 (2016). https://doi.org/10.1007/s12094-015-1371-2

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  • DOI: https://doi.org/10.1007/s12094-015-1371-2

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