Does the radiation approach affect acute toxicity in prostate cancer patients? A comparison of four radiation techniques

INTRODUCTION: Prostate cancer is treated with increasingly sophisticated radiation techniques. The aim of the study is to compare acute toxicity in patients managed with different therapeutic modalities. MATERIAL AND METHODS: A total of 60 patients irradiated between 2012 and 2016 were analyzed: A. conformal 3D – 11, B. intensity-modulated radiation therapy (IMRT) 20, C. image-guided radiation therapy (IGRT) – 19 and D. volumetric modulated arc therapy (VMAT) – 10. Patients' age ranged from 46 to 85 years (median 70.5), prostate-specific antigen values at the time of diagnosis were in the range of 3.54–154 ng/ml (median 15.9). Acute toxicity from the genitourinary (GU) and gastrointestinal (GI) tracts according to the European Organization for Research and Treatment of Cancer (EORTC) /Radiation Therapy Oncology Group (RTOG) grading system were assessed. RESULTS: All irradiation techniques were well tolerated and neither 3 nor 4 degrees acute toxicity was observed. Importantly, IGRT and IMRT did not lead to Grade 2 GI acute toxicity. There was no relationship between the severity of GU acute toxicity depending on the irradiation technique used (p = 0.8), but a trend towards a significant relationship was noted for GI acute toxicity (p = 0.05). CONCLUSIONS: All assessed irradiation methods do not lead to severe acute adverse effects. Importantly, patients treated with IGRT and IMRT had only minor GI toxicity.