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Ethnic difference in risk of toxicity in prostate cancer patients treated with dynamic arc radiation therapy

Abstract

Aims and background

The objective of this study was to assess the influence of ethnicity on toxicity in patients treated with dynamic arc radiation therapy (ART) for prostate cancer (PC).

Methods

From June 2006 to May 2012, 162 cT1-T3 cN0 cM0 PC patients were treated with ART (primary diagnosis, n = 125; post-prostatectomy/brachytherapy biochemical recurrence, n = 26; adjuvant post-prostatectomy, n = 11) at 2 institutions. Forty-five patients were Latin Americans and 117 were Europeans. The dose prescribed to the prostate ranged between 68 Gy and 81 Gy.

Results

The median age was 69 years (range 43-87 years). The median follow-up was 18 months (range 2-74 months). Overall, only 3 patients died, none due to a cancer-related cause. Biochemical recurrence was seen in 7 patients. The rates of acute grade 2 gastrointestinal (GI) and genitourinary (GU) toxicities were 19.7% and 17%, respectively. Only 1 patient experienced acute grade 3 GI toxicity, whereas 11 patients (6.7%) experienced acute grade 3 GU toxicity. Multivariate analysis showed that undergoing whole pelvic lymph node irradiation was associated with a higher grade of acute GI toxicity (OR: 3.46; p = 0.003). In addition, older age was marginally associated with a higher grade of acute GI toxicity (OR: 2.10; p = 0.074). Finally, ethnicity was associated with acute GU toxicity: Europeans had lower-grade toxicity (OR: 0.27; p = 0.001).

Conclusions

Our findings suggest an ethnic difference in GU toxicity for PC patients treated with ART. In addition, we found that ART is associated with a very low risk of severe toxicity and a low recurrence rate.

Tumori 2015; 101(4): 461 - 468

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000346

Authors

Jose L. Lopez Guerra, Raul Matute, Fernando Puebla, Alberto Sánchez-Reyes, Beatriz Pontes, Cristina Rubio, Isabel Nepomuceno, Catalina Acevedo, Nicolas Isa, Rafael Lengua, Juan Manuel Praena-Fernandez, Eleonor Rivin del Campo, Maria Jose Ortiz, Ignacio Azinovic

Article History

Disclosures

Financial support: None.
Conflict of interest: The authors have no conflicts of interest related to this study.

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Authors

Affiliations

  • Department of Radiation Oncology, University Hospital Virgen del Rocio, Sevilla - Spain
  • Master in Advanced Technological Applications in Radiation Oncology, University of Murcia and Grupo IMO Foundation, Madrid - Spain
  • Department of Radiation Oncology, Oncology Institute of Madrid/Grupo IMO, Madrid - Spain
  • Department of Radiation Oncology, San Carlos Clinical Hospital, Madrid - Spain
  • Radiation Physics, Oncology Institute of Madrid/Grupo IMO, Madrid - Spain
  • Department of Computer Language and Systems, University of Sevilla, Sevilla - Spain
  • Department of Radiation Oncology, Valle del Lili Foundation, Cali - Colombia
  • Department of Radiation Oncology, National Cancer Institution, Santiago de Chile - Chile
  • Department of Radiation Oncology, Hope International Hospital, Guatemala - Guatemala
  • Methodology Unit, Andalusian Public Foundation for Research Management in Healthcare of Sevilla, Virgen del Rocío University Hospital, Sevilla - Spain
  • Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, Paris - France

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