Acute toxicity in prostate cancer patients treated with and without image-guided radiotherapy

Suki Gill, Jessica Thomas, Chris Fox, Tomas Kron, Aldo Rolfo, Mary Leahy, Sarat Chander, Scott Williams, Keen Hun Tai, Gillian M. Duchesne, Farshad Foroudi

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Abstract

Background: 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.Methods: 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.Results: 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 ≥G3 affected 23% and 7% in the non-IGRT and IGRT group respectively (p = 0.0188). Diarrhoea ≥G2 affected 15% and 3% of patients in the non-IGRT and IGRT groups (p = 0.0174). Fatigue ≥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 ≥G2 (p = 0.0179) and ≥G3 frequency (p = 0.0027), ≥G2 diarrhoea (p = 0.0033) and ≥G2 fatigue (p = 0.0088) in the non-IGRT group compared to the IGRT group. Other toxicities were not of significant statistical difference.Conclusions: 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.

Original languageEnglish
Article number145
JournalRadiation Oncology
Volume6
Issue number1
DOIs
Publication statusPublished - 28 Oct 2011
Externally publishedYes

Keywords

  • Acute toxicity
  • Image-guided radiotherapy
  • Prostate cancer

Cite this

Gill, S., Thomas, J., Fox, C., Kron, T., Rolfo, A., Leahy, M., ... Foroudi, F. (2011). Acute toxicity in prostate cancer patients treated with and without image-guided radiotherapy. Radiation Oncology, 6(1), [145]. https://doi.org/10.1186/1748-717X-6-145
Gill, Suki ; Thomas, Jessica ; Fox, Chris ; Kron, Tomas ; Rolfo, Aldo ; Leahy, Mary ; Chander, Sarat ; Williams, Scott ; Tai, Keen Hun ; Duchesne, Gillian M. ; Foroudi, Farshad. / Acute toxicity in prostate cancer patients treated with and without image-guided radiotherapy. In: Radiation Oncology. 2011 ; Vol. 6, No. 1.
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abstract = "Background: 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.Methods: 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.Results: 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 ≥G3 affected 23{\%} and 7{\%} in the non-IGRT and IGRT group respectively (p = 0.0188). Diarrhoea ≥G2 affected 15{\%} and 3{\%} of patients in the non-IGRT and IGRT groups (p = 0.0174). Fatigue ≥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 ≥G2 (p = 0.0179) and ≥G3 frequency (p = 0.0027), ≥G2 diarrhoea (p = 0.0033) and ≥G2 fatigue (p = 0.0088) in the non-IGRT group compared to the IGRT group. Other toxicities were not of significant statistical difference.Conclusions: 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.",
keywords = "Acute toxicity, Image-guided radiotherapy, Prostate cancer",
author = "Suki Gill and Jessica Thomas and Chris Fox and Tomas Kron and Aldo Rolfo and Mary Leahy and Sarat Chander and Scott Williams and Tai, {Keen Hun} and Duchesne, {Gillian M.} and Farshad Foroudi",
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Gill, S, Thomas, J, Fox, C, Kron, T, Rolfo, A, Leahy, M, Chander, S, Williams, S, Tai, KH, Duchesne, GM & Foroudi, F 2011, 'Acute toxicity in prostate cancer patients treated with and without image-guided radiotherapy', Radiation Oncology, vol. 6, no. 1, 145. https://doi.org/10.1186/1748-717X-6-145

Acute toxicity in prostate cancer patients treated with and without image-guided radiotherapy. / Gill, Suki; Thomas, Jessica; Fox, Chris; Kron, Tomas; Rolfo, Aldo; Leahy, Mary; Chander, Sarat; Williams, Scott; Tai, Keen Hun; Duchesne, Gillian M.; Foroudi, Farshad.

In: Radiation Oncology, Vol. 6, No. 1, 145, 28.10.2011.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Acute toxicity in prostate cancer patients treated with and without image-guided radiotherapy

AU - Gill, Suki

AU - Thomas, Jessica

AU - Fox, Chris

AU - Kron, Tomas

AU - Rolfo, Aldo

AU - Leahy, Mary

AU - Chander, Sarat

AU - Williams, Scott

AU - Tai, Keen Hun

AU - Duchesne, Gillian M.

AU - Foroudi, Farshad

PY - 2011/10/28

Y1 - 2011/10/28

N2 - Background: 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.Methods: 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.Results: 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 ≥G3 affected 23% and 7% in the non-IGRT and IGRT group respectively (p = 0.0188). Diarrhoea ≥G2 affected 15% and 3% of patients in the non-IGRT and IGRT groups (p = 0.0174). Fatigue ≥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 ≥G2 (p = 0.0179) and ≥G3 frequency (p = 0.0027), ≥G2 diarrhoea (p = 0.0033) and ≥G2 fatigue (p = 0.0088) in the non-IGRT group compared to the IGRT group. Other toxicities were not of significant statistical difference.Conclusions: 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.

AB - Background: 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.Methods: 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.Results: 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 ≥G3 affected 23% and 7% in the non-IGRT and IGRT group respectively (p = 0.0188). Diarrhoea ≥G2 affected 15% and 3% of patients in the non-IGRT and IGRT groups (p = 0.0174). Fatigue ≥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 ≥G2 (p = 0.0179) and ≥G3 frequency (p = 0.0027), ≥G2 diarrhoea (p = 0.0033) and ≥G2 fatigue (p = 0.0088) in the non-IGRT group compared to the IGRT group. Other toxicities were not of significant statistical difference.Conclusions: 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.

KW - Acute toxicity

KW - Image-guided radiotherapy

KW - Prostate cancer

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U2 - 10.1186/1748-717X-6-145

DO - 10.1186/1748-717X-6-145

M3 - Article

VL - 6

JO - Radiation oncology (London, England)

JF - Radiation oncology (London, England)

SN - 1748-717X

IS - 1

M1 - 145

ER -