Grading-system-dependent volume effects for late radiation-induced rectal toxicity after curative radiotherapy for prostate cancer |
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Authors: | van der Laan Hans Paul van den Bergh Alphons Schilstra Cornelis Vlasman Renske Meertens Harm Langendijk Johannes A |
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Affiliation: | Department of Radiation Oncology, University Medical Center Groningen/University of Groningen, Groningen, The Netherlands. h.p.van.der.laan@rt.umcg.nl |
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Abstract: | PURPOSE: To assess the association between the dose distributions in the rectum and late Radiation Therapy Oncology Group and the European Organisation for Research and Treatment of Cancer (RTOG/EORTC), Late Effects of Normal Tissue SOMA, and Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 graded rectal toxicity among patients with prostate cancer treated with RT. METHODS AND MATERIALS: Included in the study were 124 patients who received three-dimensional conformal RT for prostate cancer to a total dose of 70 Gy in 2-Gy fractions. All patients completed questionnaires regarding rectum complaints before RT and during long-term follow-up. Late rectum Grade 2 or worse toxicity, according to RTOG/EORTC, LENT SOMA, and CTCAE v3.0 criteria, was analyzed in relation to rectal dose and volume parameters. RESULTS: Dose-volume thresholds (V40>or=65%, V50>or=55%, V65>or=45%, V70>or=20%, and a rectum volumeor=70 Gy (V70) was most predictive for late Grade 2 or worse rectal toxicity with each of the grading systems. The associations were strongest, however, with use of the LENT SOMA system. CONCLUSIONS: Volume effects for late radiation-induced rectal toxicity are present, but their clinical significance depends on the grading system used. This should be taken into account in the interpretation of studies reporting on radiation-induced rectal toxicity. |
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Keywords: | Prostate cancer Radiotherapy Dose-volume effects Rectal toxicity Toxicity grading systems |
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