Tomotherapy for prostate adenocarcinoma: a report on acute toxicity.
OBJECTIVE
To analyze the impact of Tomotherapy (TOMO) intensity modulated radiotherapy (IMRT) on acute gastrointestinal (GI) and genitourinary (GU) toxicity in prostate cancer.


METHODS
The records of 55 consecutively treated TOMO patients were reviewed. Additionally a well-matched group of 43 patients treated with LINAC-based step and shoot IMRT (LINAC) was identified. Acute toxicity was scored according to Radiation Therapy Oncology Group acute toxicity criterion.


RESULTS
The grade 2-3 acute GU toxicity rates for the TOMO vs. LINAC groups were 51% vs. 28% (p=0.001). Acute grade 2 GI toxicity was 25% vs. 40% (p=0.024), with no grade 3 GI toxicity in either group. In univariate analysis, androgen deprivation, prostate volume, pre-treatment urinary toxicity, and prostate dose homogeneity correlated with acute GI and GU toxicity. With multivariate analysis use of Tomotherapy, median bladder dose and bladder dose homogeneity remained significantly correlated with GU toxicity.


CONCLUSIONS
Acute GI toxicity for prostate cancer is improved with Tomotherapy at a cost of increased acute GU toxicity possibly due to differences in bladder and prostate dose distribution.
Keiler
Louis
L
Department of Radiation Oncology, University Hospitals of Cleveland, Cleveland, OH 44106, USA. louis.keiler@uhhospitals.org
Dobbins
Donald
D
Kulasekere
Ravi
R
Einstein
Douglas
D
D000230:Adenocarcinoma / Q000532:radiotherapy*; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000187:drug effects; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D001743:Urinary Bladder / Q000187:drug effects