BACKGROUND AND PURPOSE: DUE01 is an observational study aimed at developing predictive models of genito-urinary toxicity of patients treated for prostate cancer with conventional (1.8-2Gy/fr, CONV) or moderate hypo-fractionation (2.35-2.7Gy/fr, HYPO).
The current analysis focused on the relationship between bladder DVH/DSH and the risk of International Prostate Symptoms Score (IPSS)⩾15/20 at the end of radiotherapy.
MATERIALS AND METHODS: Planning and relevant clinical parameters were prospectively collected, including DVH/DSH, LQ-corrected (DVHc/DSHc) and weekly (DVHw/DSHw) histograms. Best parameters were selected by the differences between patients with/without IPSS⩾15/20 at the end of radiotherapy. Logistic uni- and backward multi-variable (MVA) analyses were performed.
RESULTS: Data of 247 patients were available (CONV: 116, HYPO: 131). Absolute DVHw/DSHw and DVHc/DSHc predicted the risk of IPSS⩾15 at the end of radiotherapy (n=77/247); an MVA model including baseline IPSS, anti-hypertensive, T stage, the absolute surface receiving ⩾8.5Gy/week and ⩾12.5Gy/week was developed (AUC=0.78, 95% CI: 0.72-0.83). Similar AUC values were found if replacing DSHw with DVHw/DVHc/DSHc parameters. The impact of dose-volume/surface parameters remained when excluding patients with baseline IPSS⩾15 and in HYPO. IPSS⩾20 at the end of radiotherapy (n=27/247) was mainly correlated to baseline IPSS and T stage.
CONCLUSIONS: Although the baseline IPSS was the main predictor, constraining v8.5w< 56cc and v12.5w< 5cc may significantly reduce acute GU toxicity.
Written by:
Carillo V, Cozzarini C, Rancati T, Avuzzi B, Botti A, Borca VC, Cattari G, Civardi F, Esposti CD, Franco P, Girelli G, Maggio A, Muraglia A, Palombarini M, Pierelli A, Pignoli E, Vavassori V, Zeverino M, Valdagni R, Fiorino C. Are you the author?
Institution(s): See publishing journal.
Reference: Radiother Oncol. 2014 Mar 13. pii: S0167-8140(14)00098-X.
doi: 10.1016/j.radonc.2014.02.006
PubMed Abstract
PMID: 24631144
UroToday.com Prostate Cancer Section
