Early biomarkers related to secondary primary cancer risk in radiotherapy treated prostate cancer patients: IMRT versus IMAT - Abstract

PURPOSE: To investigate whether rotational techniques (Volumetric Modulated Arc Therapy - VMAT) are associated with a higher risk for secondary primary malignancies compared to step-and-shoot Intensity Modulated Radiation Therapy (ss-IMRT).

To this end, radiation therapy (RT) induced DNA double-strand-breaks and the resulting chromosomal damage were assessed in peripheral blood T-lymphocytes of prostate cancer (PCa) patients applying γH2AX foci and G0 micronucleus (MN) assays.

METHODS AND MATERIALS: The study comprised 33PCa patients. A blood sample was taken before start of therapy and after the 1st and 3rd RT fraction to determine respectively the RT-induced γH2AX foci and MN. The equivalent total body dose (DETB) was calculated based on treatment planning data.

RESULTS: A linear dose response was obtained for γH2AX foci yields versus DETB while MN showed a linear-quadratic dose response. Patients treated with large volume (LV) VMAT show a significantly higher level of induced γH2AX foci and MN compared to IMRT and small volume (SV) VMAT (p< 0.01). Assuming a linear-quadratic relationship, a satisfactory correlation was found between both endpoints (R2 0.86).

CONCLUSIONS: Biomarker responses were governed by dose and irradiated volume of normal tissues. No significant differences between IMRT and rotational therapy inherent to the technique itself were observed.

Written by:
Werbrouck J, Ost P, Fonteyne V, De Meerleer G, De Neve W, Bogaert E, Beels L, Bacher K, Vral A, Thierens H.   Are you the author?
Department of Basic Medical Sciences, Ghent University, Gent, Belgium.

Reference: Radiother Oncol. 2013 Jun 19. pii: S0167-8140(13)00228-4.
doi: 10.1016/j.radonc.2013.05.014


PubMed Abstract
PMID: 23791364

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