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Salvage reirradiation for local failure of prostate cancer after curative radiation therapy: Association of rectal toxicity with dose distribution and normal-tissue complication probability models

PURPOSE: This study aimed to assess the impact of radiation dose on rectal toxicity after salvage external beam radiation therapy (EBRT) with or without a brachytherapy boost for exclusive local failures after the primary EBRT for prostate cancer. METHODS AND MATERIALS: Fourteen patients with no sev...

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Autores principales: Dipasquale, Giovanna, Zilli, Thomas, Fiorino, Claudio, Rouzaud, Michel, Miralbell, Raymond
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200893/
https://www.ncbi.nlm.nih.gov/pubmed/30370369
http://dx.doi.org/10.1016/j.adro.2018.06.001
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author Dipasquale, Giovanna
Zilli, Thomas
Fiorino, Claudio
Rouzaud, Michel
Miralbell, Raymond
author_facet Dipasquale, Giovanna
Zilli, Thomas
Fiorino, Claudio
Rouzaud, Michel
Miralbell, Raymond
author_sort Dipasquale, Giovanna
collection PubMed
description PURPOSE: This study aimed to assess the impact of radiation dose on rectal toxicity after salvage external beam radiation therapy (EBRT) with or without a brachytherapy boost for exclusive local failures after the primary EBRT for prostate cancer. METHODS AND MATERIALS: Fourteen patients with no severe residual late toxicity after primary EBRT ± brachytherapy were reirradiated after a median time interval of 6.1 years. The median normalized total dose in 2 Gy fractions (NTD(2Gy), α/β ratio = 1.5 Gy for prostate cancer cells) was 74 Gy at primary EBRT and 85.1 Gy at reirradiation. Rectal dose-volume histograms (converted to NTD(2Gy_alpha/beta = 3 Gy)) and the corresponding normal-tissue complication probability (NTCP) values for gastrointestinal (GI) toxicity were evaluated for 2 groups: High GI toxicity (grade ≥3) and low GI toxicity (grade ≤2). RESULTS: The 5-year grade ≥3 GI toxicity-free survival rate was 57.1%. The median rectal V(70Gy) and maximum dose to 1 cm(3) (D1cc(rect)) at primary EBRT were both predictive for grade ≥3 GI toxicity (9% vs 0%; P = .04 and 72.2 Gy vs 66.8 Gy; P < .01, respectively). When adding primary radiation therapy (RT) and reirradiation plans, the median D1cc(rect) was 139.8 Gy versus 126.7 Gy (P < .01) for high and low GI toxicity groups. NTCP >10% at primary RT was predictive for high GI toxicity at reirradiation (P < .05). CONCLUSIONS: Even in the absence of residual toxicity after primary RT, rectal doses >70 Gy and NTCP >10% calculated for a first irradiation may be associated with a higher risk of developing high GI toxicity at reirradiation with a possible D1cc(rect) threshold of 130 Gy.
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spelling pubmed-62008932018-10-26 Salvage reirradiation for local failure of prostate cancer after curative radiation therapy: Association of rectal toxicity with dose distribution and normal-tissue complication probability models Dipasquale, Giovanna Zilli, Thomas Fiorino, Claudio Rouzaud, Michel Miralbell, Raymond Adv Radiat Oncol Physics Contribution PURPOSE: This study aimed to assess the impact of radiation dose on rectal toxicity after salvage external beam radiation therapy (EBRT) with or without a brachytherapy boost for exclusive local failures after the primary EBRT for prostate cancer. METHODS AND MATERIALS: Fourteen patients with no severe residual late toxicity after primary EBRT ± brachytherapy were reirradiated after a median time interval of 6.1 years. The median normalized total dose in 2 Gy fractions (NTD(2Gy), α/β ratio = 1.5 Gy for prostate cancer cells) was 74 Gy at primary EBRT and 85.1 Gy at reirradiation. Rectal dose-volume histograms (converted to NTD(2Gy_alpha/beta = 3 Gy)) and the corresponding normal-tissue complication probability (NTCP) values for gastrointestinal (GI) toxicity were evaluated for 2 groups: High GI toxicity (grade ≥3) and low GI toxicity (grade ≤2). RESULTS: The 5-year grade ≥3 GI toxicity-free survival rate was 57.1%. The median rectal V(70Gy) and maximum dose to 1 cm(3) (D1cc(rect)) at primary EBRT were both predictive for grade ≥3 GI toxicity (9% vs 0%; P = .04 and 72.2 Gy vs 66.8 Gy; P < .01, respectively). When adding primary radiation therapy (RT) and reirradiation plans, the median D1cc(rect) was 139.8 Gy versus 126.7 Gy (P < .01) for high and low GI toxicity groups. NTCP >10% at primary RT was predictive for high GI toxicity at reirradiation (P < .05). CONCLUSIONS: Even in the absence of residual toxicity after primary RT, rectal doses >70 Gy and NTCP >10% calculated for a first irradiation may be associated with a higher risk of developing high GI toxicity at reirradiation with a possible D1cc(rect) threshold of 130 Gy. Elsevier 2018-06-15 /pmc/articles/PMC6200893/ /pubmed/30370369 http://dx.doi.org/10.1016/j.adro.2018.06.001 Text en © 2018 The Author http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Physics Contribution
Dipasquale, Giovanna
Zilli, Thomas
Fiorino, Claudio
Rouzaud, Michel
Miralbell, Raymond
Salvage reirradiation for local failure of prostate cancer after curative radiation therapy: Association of rectal toxicity with dose distribution and normal-tissue complication probability models
title Salvage reirradiation for local failure of prostate cancer after curative radiation therapy: Association of rectal toxicity with dose distribution and normal-tissue complication probability models
title_full Salvage reirradiation for local failure of prostate cancer after curative radiation therapy: Association of rectal toxicity with dose distribution and normal-tissue complication probability models
title_fullStr Salvage reirradiation for local failure of prostate cancer after curative radiation therapy: Association of rectal toxicity with dose distribution and normal-tissue complication probability models
title_full_unstemmed Salvage reirradiation for local failure of prostate cancer after curative radiation therapy: Association of rectal toxicity with dose distribution and normal-tissue complication probability models
title_short Salvage reirradiation for local failure of prostate cancer after curative radiation therapy: Association of rectal toxicity with dose distribution and normal-tissue complication probability models
title_sort salvage reirradiation for local failure of prostate cancer after curative radiation therapy: association of rectal toxicity with dose distribution and normal-tissue complication probability models
topic Physics Contribution
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200893/
https://www.ncbi.nlm.nih.gov/pubmed/30370369
http://dx.doi.org/10.1016/j.adro.2018.06.001
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