Three-dimensional conformal external beam radiotherapy versus the combination of external radiotherapy with high-dose rate brachytherapy in localized carcinoma of the prostate: comparison of acute toxicity.
OBJECTIVE
Radiotherapy represents one of the basic therapeutic methods in treatment of localized carcinoma of the prostate. Optimal irradiation dose is the cornerstone of a successful treatment. Along with local control of the disease and overall survival of the patient, possible acute and long-term side effects need to be monitored very closely.


METHODS
A non-randomized prospective study comparing the acute genitourinary and gastrointestinal toxicity in patients irradiated for localized carcinoma of the prostate. Fifty-seven patients were treated with three-dimensional conformal external beam radiotherapy alone, and in the second treatment arm a combination of external beam radiotherapy and high-dose rate brachytherapy was employed in 40 patients.


RESULTS
Three-dimensional conformal external beam radiotherapy. Acute G1 genitourinary toxicity was recorded in 35.1% of patients, G2 in 22.8%, and G2-3 in one patient (1.7%). Acute gastrointestinal toxicity was experienced by 54.4% of patients, G1 in 28.1%, G2 in 17.5%, and G3 in 8.8%. Three-dimensional conformal external beam radiotherapy + brachytherapy. Acute G1 genitourinary toxicity was recorded in 37.5% and grade 2 in 15% of the patients. Only G1 acute gastrointestinal toxicity was recorded in 40% of the patients.


CONCLUSIONS
Acute G1 genitourinary toxicity was experienced by a similar percentage of patients in both treatment arms. Acute G2 genitourinary toxicity was more frequent in the three-dimensional conformal radiotherapy arm. Higher acute genitourinary toxicity, G3 or G4, was recorded only in one patient per treatment arm. Acute gastrointestinal toxicity was more frequent in the three-dimensional conformal radiotherapy arm. Higher acute gastrointestinal toxicity, G2 and G3, was only observed in the three-dimensional conformal radiotherapy arm. The acute toxicity observed was of a low grade. The combination of external beam radiotherapy with brachytherapy resulted in a lower incidence of gastrointestinal toxicity than external beam radiotherapy alone.
Soumarová
Renata
R
JG Mendel Cancer Center Nový Jicín, Hospital Nový Jicín, Czech Republic. renata.soumarova@radioterapie.cz
Homola
Lubos
L
Perková
Hana
H
Stursa
Miroslav
M
D000230:Adenocarcinoma / Q000532:radiotherapy*; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects*; D041981:Gastrointestinal Tract / Q000528:radiation effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D014566:Urogenital System / Q000528:radiation effects