Academic Journal
Late urinary toxicity modeling after stereotactic body radiotherapy (SBRT) in the definitive treatment of localized prostate cancer.
| Τίτλος: | Late urinary toxicity modeling after stereotactic body radiotherapy (SBRT) in the definitive treatment of localized prostate cancer. |
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| Συγγραφείς: | Kole TP; a Department of Radiation Medicine , Georgetown University Hospital , Washington , DC , USA., Tong M; a Department of Radiation Medicine , Georgetown University Hospital , Washington , DC , USA., Wu B; a Department of Radiation Medicine , Georgetown University Hospital , Washington , DC , USA., Lei S; a Department of Radiation Medicine , Georgetown University Hospital , Washington , DC , USA., Obayomi-Davies O; a Department of Radiation Medicine , Georgetown University Hospital , Washington , DC , USA., Chen LN; a Department of Radiation Medicine , Georgetown University Hospital , Washington , DC , USA., Suy S; a Department of Radiation Medicine , Georgetown University Hospital , Washington , DC , USA., Dritschilo A; a Department of Radiation Medicine , Georgetown University Hospital , Washington , DC , USA., Yorke E; b Department of Radiation Oncology , Memorial Sloan-Kettering Cancer Center , New York, New York , USA., Collins SP; a Department of Radiation Medicine , Georgetown University Hospital , Washington , DC , USA. |
| Πηγή: | Acta oncologica (Stockholm, Sweden) [Acta Oncol] 2016; Vol. 55 (1), pp. 52-8. Date of Electronic Publication: 2015 May 14. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Medical Journals Sweden AB Country of Publication: Sweden NLM ID: 8709065 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1651-226X (Electronic) Linking ISSN: 0284186X NLM ISO Abbreviation: Acta Oncol Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2024- : [Uppsala, Sweden] : Medical Journals Sweden AB Original Publication: Stockholm, Sweden : Acta Oncologica, [1987- |
| Ιατρικοί όροι (MeSH): | Organs at Risk/*radiation effects , Prostatic Neoplasms/*surgery , Radiosurgery/*adverse effects , Urinary Bladder/*radiation effects, Prostatic Neoplasms/pathology ; Urination Disorders/etiology ; Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Probability ; Radiation Dose Hypofractionation ; Regression Analysis ; Retrospective Studies |
| Περίληψη: | Background: Late urinary symptom flare has been shown to occur in a small subset of men treated with ultra- hypofractionated stereotactic body radiotherapy (SBRT) for prostate cancer. The purpose of this study was to use normal tissue complication probability modeling in an effort to derive SBRT specific dosimetric predictor's of late urinary flare. Material and Methods: Two hundred and sixteen men were treated for localized prostate cancer using ultra- hypofractionated SBRT. A dose of 35-36.25 Gy in 5 fractions was delivered to the prostate and proximal seminal vesicles. Functional surveys were conducted before and after treatment to assess late toxicity. Phenomenologic NTCP models were fit to bladder DVHs and late urinary flare outcomes using maximum likelihood estimation. Results: Twenty-nine patients experienced late urinary flare within two years of completion of treatment. Fitting of bladder DVH data to a Lyman NTCP model resulted in parameter estimates of m, TD50, and n of 0.19 (0-0.47), 38.7 Gy (31.1-46.4), and 0.13 (-0.14-0.41), respectively. Subsequent fit to a hottest volume probit model revealed a significant association of late urinary flare with dose to the hottest 12.7% of bladder volume. Multivariate analysis resulted in a final model that included patient age and hottest volume probit model predictions. Kaplan-Meier analysis demonstrated a two-year urinary flare free survival of 95.7% in patients 65 years or older with a bladder D12.7% of 33.5 Gy or less, compared to 74.5% in patients meeting none of these criteria. Conclusion: NTCP modeling of late urinary flare after ultra-hypofractionated prostate SBRT demonstrates a relatively small volume effect for dose to the bladder, suggesting that reduction of volume receiving elevated dose will result in decreased incidence of late urinary toxicity. Future studies will be needed to examine the impact of dose to other potential sources of late genitourinary toxicity. |
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| Grant Information: | P30 CA008748 United States CA NCI NIH HHS |
| Entry Date(s): | Date Created: 20150515 Date Completed: 20161213 Latest Revision: 20220318 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC4986047 |
| DOI: | 10.3109/0284186X.2015.1037011 |
| PMID: | 25972264 |
| Βάση Δεδομένων: | MEDLINE |
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