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Comparison of acute and subacute genitourinary and gastrointestinal adverse events of radiotherapy for prostate cancer using intensity-modulated radiation therapy, three-dimensional conformal radiation therapy, permanent implant brachytherapy and high-dose-rate brachytherapy

Abstract

Aims and background. To examine acute and subacute urinary and rectal toxicity in patients with localized prostate cancer monotherapeutically treated with the following four radiotherapeutic techniques: intensity-modulated radiation therapy, threedimensional conformal radiation therapy, low-dose-rate permanent implant brachytherapy using I-125 seeds, and high-dose-rate brachytherapy.
Methods.One hundred and fifty-six patients with localized prostate cancer were distributed as follows: 57 underwent intensity-modulated radiation therapy, 35 underwent three-dimensional conformal radiation therapy, 37 underwent I-125 implant, and 27 underwent high-dose-rate brachytherapy. The prescribed doses were 70-74 Gy/35-37 fractions, 70 Gy/35 fractions, 145 Gy, and 45.5 Gy/7 fraction/4 days for intensity-modulated radiation therapy, three-dimensional conformal radiation therapy, I-125 implant, and high-dose-rate brachytherapy, respectively. Toxicities (≤(6 months) were retrospectively evaluated using the Common Terminology Criteria for Adverse Events version 4.03.
Results.The frequency of grade 1 or 2 urinary toxicities using three-dimensional conformal radiation therapy (33/35, 94%) was significantly higher than that with high-doserate brachytherapy (18/27, 67%) or intensity-modulated radiation therapy (37/57, 65%) (P >0.05). The frequency of grade 1 or 2 urinary toxicities using I-125 implant was 31/37, 84%. The frequency of grade 1 or 2 gastrointestinal toxicities using three-dimensional conformal radiation therapy (17/35, 49%) was significantly higher than that using I-125 implant (4/37, 11%) or high-dose-rate brachytherapy (0/27, 0%) (P >0.05). Using intensity-modulated radiation therapy, the frequency of grade 1 or 2 gastrointestinal toxicities was 18/57 (32%), which was significantly higher than that using high-dose-rate brachytherapy (0/27, 0%) (P >0.05). Grade 3 or greater adverse events were not observed.
Conclusions. Acute and subacute genitourinary toxicities were observed more frequently after three-dimensional conformal radiation therapy than after high-doserate brachytherapy or intensity-modulated radiation therapy. Acute and subacute gastrointestinal toxicities were seen more often after three-dimensional conformal radiation therapy than after brachytherapy (I-125 implant or high-dose-rate brachytherapy).

Tumori 2014; 100(3): 265 - 271

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.1700/1578.17198

Authors

Masahiro Morimoto, Yasuo Yoshioka, Koji Konishi, Fumiaki Isohashi, Yutaka Takahashi, Toshiyuki Ogata, Masahiko Koizumi, Teruki Teshima, Henk P. Bijl, Arjen van der Schaaf, Johannes A. Langendijk, Kazuhiko Ogawa

Article History

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Authors

  • Morimoto, Masahiro [PubMed] [Google Scholar]
    Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Japan
  • Yoshioka, Yasuo [PubMed] [Google Scholar]
    Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Japan
  • Konishi, Koji [PubMed] [Google Scholar]
    Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Japan
  • Isohashi, Fumiaki [PubMed] [Google Scholar]
    Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Japan
  • Takahashi, Yutaka [PubMed] [Google Scholar]
    Division of Medical Physics, Oncology Center, Osaka University Hospital, Japan
  • Ogata, Toshiyuki [PubMed] [Google Scholar]
    Division of Medical Physics, Oncology Center, Osaka University Hospital, Japan
  • Koizumi, Masahiko [PubMed] [Google Scholar]
    Division of Medical Physics, Oncology Center, Osaka University Hospital, Japan
  • Teshima, Teruki [PubMed] [Google Scholar]
    Department of Medical Physics & Engineering, Osaka University Graduate School of Medicine, Suita, Japan
  • Bijl, Henk P. [PubMed] [Google Scholar]
    Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  • Schaaf, Arjen van der [PubMed] [Google Scholar]
    Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  • Langendijk, Johannes A. [PubMed] [Google Scholar]
    Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  • Ogawa, Kazuhiko [PubMed] [Google Scholar]
    Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Japan

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