title: Does pelvic lymph nodes irradiation using intensity modulated radiation therapy increase rectal and bladder toxicities in patients with prostate carcinoma?
abstract: OBJECTIVE
  this study compared the radiation-related rectal (R) and bladder (B) toxicities in prostate carcinoma patients receiving additional pelvic lymph nodes (PLN) irradiation with those receiving prostate (P) and seminal vesicle (SV) irradiation only.
  
  
  METHODS
  thirty-three patients treated with intensity modulated radiation therapy (IMRT) were included. RT doses ranged between 60- 66.6 Gy to SV, 74-77.7 Gy to P and 50.4- 60 Gy to PLN. Max acute R toxicity was graded by a physician according to the RTOG side effect criteria during the period from the initiation of therapy until the end of the third month. Max late R and B toxicities were graded 3 months after the completion of RT by a physician using the RTOG GI and urogenital toxicity score and by patients using EORTC QLQ - PR25 self questionnaire separately. The effects of R and B doses and additional PLN irradiation on acute and late R and B toxicities and compatibility of patient- and physician-graded toxicity scores were investigated. RTOG GI and urogenital toxicity scores and EORTC QLQ - PR25 self questionnaire results were correlated.
  
  
  RESULTS
  significant factors for acute R toxicity were: max R; R volume receiving ≥ 68 Gy; and PLN irradiation. PLN irradiation was marginally significant for late R toxicity; the mean B dose was a significant factor for late B toxicity.
  
  
  CONCLUSIONS
  the results of this study suggest that although PLN irradiation increased acute R toxicity, it has no effect on late R and B toxicity. Patient- and physician-evaluated late R and B toxicity scores were concordant.
authors.affiliation: Acibadem University, Department of Radiation Oncology, Istanbul, Turkey. mgaripagaoglu@asg.com.tr
authors.forename: M
authors.initials: M
authors.lastname: Garipagaoglu
authors.forename: M
authors.initials: M
authors.lastname: Sengoz
authors.forename: O
authors.initials: O
authors.lastname: Senkesen
authors.forename: E
authors.initials: E
authors.lastname: Ozan Göksel
authors.forename: E
authors.initials: E
authors.lastname: Tezcanli
authors.forename: H
authors.initials: H
authors.lastname: Kucucuk
authors.forename: I
authors.initials: I
authors.lastname: Aslay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000473:pathology / Q000528:radiation effects*; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology* / Q000473:pathology; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D012007:Rectum / Q000473:pathology / Q000528:radiation effects*; D001743:Urinary Bladder / Q000473:pathology / Q000528:radiation effects*