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The relationship between technical parameters of external beam radiation therapy and complications for localized prostate cancer.

Abstract：

BACKGROUND:This study was performed to review retrospectively the clinical course of chronic rectal bleeding as a complication of external beam radiation therapy for localized prostate cancer and to analyze the relationship between technical parameters of radiation therapy and the complications. METHODS:Seventy-one patients with stages A2, B and C were treated with local-field radiotherapy (total dose 52.5-66 Gy, daily dose 2.0-3.28 Gy, field area 30-81 cm2, number of fields 3-15 ports, planning simulations X-ray or CT-based) between 1989 and 1998 at three institutions. The protocols were consistent during this same period at these institutions. RESULTS:Multivariate analysis revealed pretreatment PSA and Gleason sum to be statistically significant predictors of 5 year prostatic specific antigen (PSA) relapse-free rates in a median follow-up period of 42 months (range 12-119 months). The significant risk factors for higher grading of acute morbidity were a biological equivalent dose, alpha/beta = 10(BED10) > or =65 Gy, dose per fraction > or =3.0 Gy, field area > or =42 cm2, fewer ports and X-ray planning simulation. However, no parameter was associated with higher grading of late morbidity. Eleven patients (15.4%) experienced a late GI complication: grade 1 (4.2%), grade 2 (9.8%), grade 3 (1.4%). The median time to occurrence of rectal bleeding was 12 months after radiotherapy and the mean duration of morbidity was 11 months. CONCLUSIONS:Higher total dose and dose per fraction, larger field area, fewer ports and X-ray simulation increased the grades of acute morbidity. A majority of chronic rectal bleedings were transient and responded to conservative treatment.

journal_name

Jpn J Clin Oncol

journal_title

Japanese journal of clinical oncology

authors

Kitamura K,Shirato H,Suzuki K,Shinohara N,Demura T,Harabayashi T,Nishioka T,Kagei K,Takayama N,Shinno Y,Kawakura K,Koyanagi T,Miyasaka K

doi

10.1093/jjco/hyd058

keywords:

subject

Has Abstract

pub_date

2000-05-01 00:00:00

pages

225-9

issue

eissn

0368-2811

issn

1465-3621

journal_volume

pub_type

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The relationship between technical parameters of external beam radiation therapy and complications for localized prostate cancer.