Late morbidity profiles in prostate cancer patients treated to 79-84 Gy by a simple four-field coplanar beam arrangement.
OBJECTIVE
To describe the frequency and magnitude of late GI and GU morbidity in prostate cancer patients treated to high dose levels with a simple three-dimensional conformal technique.


METHODS
A total of 156 intermediate- and high-risk patients were treated between January 1, 1992 and February 28, 1999 with a simple four-field three-dimensional conformal technique to 79-84 Gy. All patients were treated with a four-field conformal technique; the prostate received 82 Gy and the seminal vesicles and periprostatic tissue 46 Gy. GI and GU toxicity was scored according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Late Morbidity Grading Scale and compared using Kaplan-Meier estimates.


RESULTS
The late Grade 2 GI complication rate was 9% and 38% at 3 years for patients treated with and without rectal blocking, respectively (p = 0.0004). No Grade 3 late GI complications developed. The rate of Grade 2 late GU complications was 5%, 8%, and 12% at 12, 24, and 36 months, respectively. The Grade 3 late GU complication rate was 2% at 36 months. These differences were not statistically significant.


CONCLUSIONS
The treatment method described is a simple four-field conformal technique that can be easily implemented in the general radiation community. A dose of 79-84 Gy can be safely delivered to the prostate, with a 9% rate of late Grade 2 GI, 12% rate of late Grade 2 GU, and 2% rate of late Grade 3 GU complications.
Chism
Derek B
DB
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
Horwitz
Eric M
EM
Hanlon
Alexandra L
AL
Pinover
Wayne H
WH
Mitra
Raj K
RK
Hanks
Gerald E
GE
D004064:Digestive System / Q000528:radiation effects; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009017:Morbidity; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects* / Q000379:methods; D014566:Urogenital System / Q000528:radiation effects