Image-guided radiotherapy (IGRT) increases the accuracy of treatment delivery through daily target localisation.
We report on toxicity symptoms experienced during radiotherapy treatment, with and without IGRT in prostate cancer patients treated radically.
Between 2006 and 2009, acute toxicity data for ten symptoms were collected prospectively onto standardized assessment forms. Toxicity was scored during radiotherapy, according to the Common Terminology Criteria Adverse Events V3.0, for 275 prostate cancer patients before and after the implementation of a fiducial marker IGRT program and dose escalation from 74Gy in 37 fractions, to 78Gy in 39 fractions. Margins and planning constraints were maintained the same during the study period. The symptoms scored were urinary frequency, cystitis, bladder spasm, urinary incontinence, urinary retention, diarrhoea, haemorrhoids, proctitis, anal skin discomfort and fatigue. Analysis was conducted for the maximum grade of toxicity and the median number of days from the onset of that toxicity to the end of treatment.
In the IGRT group, 14228 toxicity scores were analysed from 249 patients. In the non-IGRT group, 1893 toxicity scores were analysed from 26 patients. Urinary frequency greater than or equal to G3 affected 23% and 7% in the non-IGRT and IGRT group respectively (p=0.0188). Diarrhoea greater than or equal to G2 affected 15% and 3% of patients in the non-IGRT and IGRT groups (p=0.0174). Fatigue greater than or equal to G2 affected 23% and 8% of patients in the non-IGRT and IGRT groups (p=0.0271). The median number of days with a toxicity was higher for greater than or equal to G2 (p=0.0179) and greater than or equal to G3 frequency (p=0.0027), greater than or equal to G2 diarrhoea (p=0.0033) and greater than or equal to G2 fatigue (p=0.0088) in the non-IGRT group compared to the IGRT group. Other toxicities were not of significant statistical difference.
In this study, prostate cancer patients treated radically with IGRT had less severe urinary frequency, diarrhoea and fatigue during treatment compared to patients treated with non-IGRT. Onset of these symptoms was earlier in the non-IGRT group. IGRT results in less acute toxicity during radiotherapy in prostate cancer.
Written by:
Gill S, Thomas J, Fox C, Kron T, Rolfo A, Leahy M, Chander S, Williams S, Tai KH, Duchesne GM, Foroudi F. Are you the author?
Reference: Radiat Oncol. 2011 Oct 28;6(1):145.
doi: 10.1186/1748-717X-6-145
PubMed Abstract
PMID: 22035354
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