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Influence of Intensity-Modulated Radiotherapy on Acute Genitourinary and Gastrointestinal Toxicity in the Treatment of Localized Prostate Cancer (p. 11-16)

The objective of this investigation is to compare acute genitourinary (GU) and gastrointestinal (GI) toxicity results of radiotherapy to localized fields delivered using intensity-modulated radiotherapy (IMRT) versus conventional radiotherapy (ConvRT). The records of 481 consecutive prostate cancer patients receiving RT to localized fields at a single institution were reviewed; 108 received IMRT and 373 received ConvRT. Acute GU and GI toxicity, as defined by the Radiation Therapy Oncology Group (RTOG) grading system, were compared using the chi-square test. Ordered logit regression analyses were performed using all major disease and treatment factors as covariates. Acute GU grade 0, 1, 2, 3, and 4 toxicity rates were 23%, 40%, 34%, 3%, and 0%, respectively, in the IMRT cohort and 31%, 37%, 30%, 1%, and 1%, respectively, in the ConvRT cohort -- these rates were not significantly different (p=0.118). Acute GI grade 0, 1, 2, 3, and 4 toxicity rates were 42%, 37%, 22%, 0%, and 0%, respectively, in the IMRT cohort and 33%, 32%, 35%, 0%, and 0%, respectively, in the ConvRT cohort -- this lower toxicity in the IMRT group was significant (p=0.013). The regression analyses showed that only IMRT use (p=0.046) predicted reduction in acute GI toxicity but no factors correlated with acute GU toxicity rate. In conclusion, in our retrospective single-institution analysis, IMRT was not associated with reduction of acute GU toxicity but was associated with a reduction of acute GI toxicity over ConvRT in the treatment of prostate cancer to localized fields.

Keywords: Prostate cancer; Intensity modulated radiotherapy; Outcomes; and Toxicity.

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TCRT February 2007

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Volume 6
No. 1 (p 1-56)
February 2007
ISSN 1533-0338

Ashesh B. Jani, M.D., M.S.E.E.*
John Gratzle, M.S.
David Correa, B.S.

Dept. of Radiation and Cellular Oncology
University of Chicago Hospitals
5758 S. Maryland Ave., MC 9006
Chicago, IL 60637, USA