title: Significant reduction of acute toxicity following pelvic irradiation with helical tomotherapy in patients with localized prostate cancer.
abstract: OBJECTIVE
  To assess and quantify the possible benefit deriving from IMRT with Helical Tomotherapy (HTT) delivery to the pelvic nodal area in patients with prostate cancer in terms of reduction of acute and late toxicities.
  
  
  METHODS
  Thirty-five patients candidate to radical or postoperative RT on whole pelvis (WPRT) were treated with HTT, while receiving a concomitant boost to the prostate or the prostatic bed (median 74.2 and 72 Gy, respectively) within a moderately hypofractionated (28-33 fractions; median HTT duration 44 days) regimen. Median and mean doses to whole pelvis were 52 and 54 Gy, respectively. One of the major goals of planning optimisation was to minimize the dose received by the intestinal cavity (IC) outside the nodal PTV.
  
  
  RESULTS
  HTT resulted to be very efficient in sparing the IC even at dose levels below 30-35 Gy and guaranteed a significant sparing of bladder and rectum even at intermediate-low doses (V20-V40). No acute Grade 3 RTOG toxicity was recorded. Eighteen G1 and two G2 GU acute toxicities, 13 G1 upper GI acute toxicities, 8 G1 and 1 G2 acute proctitis were observed; no patient experienced G2 upper GI toxicity. After a median FU of 11.5 months (>10 in 18 patients) one case of late G3 GU toxicity was reported in one post-prostatectomy treated patient; no G2 late rectal bleeding or other GI toxicity was recorded.
  
  
  CONCLUSIONS
  WPRT with HTT resulted in a very low incidence of acute Grade 2 and in the disappearance of acute Grade 3 toxicities.
authors: Department of Radiotherapy, Scientific Institute H San Raffaele, 20132 Milan, Italy. cozzarini.cesare@hsr.it
authors: Cesare
authors: C
authors: Cozzarini
authors: Claudio
authors: C
authors: Fiorino
authors: Nadia
authors: N
authors: Di Muzio
authors: Filippo
authors: F
authors: Alongi
authors: Sara
authors: S
authors: Broggi
authors: Mauro
authors: M
authors: Cattaneo
authors: Francesco
authors: F
authors: Montorsi
authors: Patrizio
authors: P
authors: Rigatti
authors: Riccardo
authors: R
authors: Calandrino
authors: Ferruccio
authors: F
authors: Fazio
mesh_terms: D006801:Humans; D008297:Male; D010388:Pelvis / Q000528:radiation effects*; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects* / Q000379:methods*; D012007:Rectum / Q000187:drug effects; D001743:Urinary Bladder / Q000528:radiation effects