Adding intensity-modulated radiotherapy to the pelvis does not worsen the adverse effect profiles compared to limited field radiotherapy in men with prostate cancer at 12-month follow-up.
To compare adverse effects and toxicity in men with high-risk or locally advanced prostate cancer when adding intensity-modulated radiotherapy (IMRT) technique to the pelvis.


METHODS
In this prospective follow-up study 180 patients treated with conformal radiotherapy (RAD) to the prostate and vesiculae seminales (boost volumes; PV) and long-term androgen deprivation therapy (LADT), were compared to 90 patients managed by LADT, RAD to the PV and additionally pelvic IMRT. Adverse effects were self-reported at baseline, at 3- and 12-month follow-up. At each time point, the patients rated a questionnaire covering urinary, bowel, and sexual function and bother, quality of life, fatigue, and mental distress.


RESULTS
At 3-month follow-up urinary and bowel functions were significantly decreased among IMRT compared to RAD. At 12-month follow-up both groups showed the same reductions within the urinary, bowel and sexual domains. RAD patients had more mental distress than IMRT patients. The scores on quality of life, fatigue and mental distress hardly influenced function or bother within the urinary, bowel or sexual domains.


CONCLUSIONS
Men treated for high-risk or locally advanced prostate cancer with a combination of LADT, RAD and IMRT including PV and pelvic structures had considerably more acute side effects at 3 months than men treated with LADT and RAD to the PV only. However, at 12-month follow-up, the observed genitourinary and gastrointestinal function and bother were similar in both groups.
Department of Oncology and Radiotherapy, Oslo University Hospital , Radiumhospitalet, Oslo , Norway.
Wolfgang
W
Lilleby
Andreas
A
Stensvold
Alv A
AA
Dahl
D000368:Aged; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D005221:Fatigue / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010388:Pelvis; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D011788:Quality of Life; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects* / Q000379:methods; D020127:Recovery of Function; D012669:Seminal Vesicles / Q000528:radiation effects; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014555:Urination Disorders / Q000209:etiology
D000726:Androgen Antagonists