Dosimetry and preliminary acute toxicity in the first 100 men treated for prostate cancer on a randomized hypofractionation dose escalation trial

Alan Pollack, Alexandra L. Hanlon, Eric M. Horwitz, Steven J. Feigenberg, Andre A. Konski, Benjamin Movsas, Richard E. Greenberg, Robert G. Uzzo, C. M.Charlie Ma, Shawn W. McNeeley, Mark K. Buyyounouski, Robert A. Price

Research output: Contribution to journalArticlepeer-review

209 Scopus citations

Abstract

Purpose: The α/β ratio for prostate cancer is postulated to be between 1 and 3, giving rise to the hypothesis that there may be a therapeutic advantage to hypofractionation. The dosimetry and acute toxicity are described in the first 100 men enrolled in a randomized trial. Patients and Methods: The trial compares 76 Gy in 38 fractions (Arm I) to 70.2 Gy in 26 fractions (Arm II) using intensity modulated radiotherapy. The planning target volume (PTV) margins in Arms I and II were 5 mm and 3 mm posteriorly and 8 mm and 7 mm in all other dimensions. The PTV D95% was at least the prescription dose. Results: The mean PTV doses for Arms I and II were 81.1 and 73.8 Gy. There were no differences in overall maximum acute gastrointestinal (GI) or genitourinary (GU) toxicity acutely. However, there was a slight but significant increase in Arm II GI toxicity during Weeks 2, 3, and 4. In multivariate analyses, only the combined rectal DVH parameter of V65 Gy/V50 Gy was significant for GI toxicity and the bladder volume for GU toxicity. Conclusion: Hypofractionation at 2.7 Gy per fraction to 70.2 Gy was well tolerated acutely using the planning conditions described.

Original languageEnglish (US)
Pages (from-to)518-526
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume64
Issue number2
DOIs
StatePublished - Feb 1 2006
Externally publishedYes

Keywords

  • Dosimetry
  • Hypofractionation
  • IMRT
  • Toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

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