A prospective comparison of acute intestinal toxicity following whole pelvic versus small field intensity-modulated radiotherapy for prostate cancer

作者：Kim Yeon Joo; Park Jin Hong; Yun In Ha; Kim Young Seok

来源：OncoTargets and Therapy, 2016, 9: 1319-1325.

DOI：10.2147/OTT.S96646

• prostate cancer
• intensity-modulated radiotherapy
• intestinal toxicity
• citrulline

Purpose: To compare the acute intestinal toxicity of whole pelvic (WP) and small field (SF) intensity-modulated radiotherapy (IMRT) for prostate cancer using dosimetric and metabolic parameters as well as clinical findings.
Methods: Patients who received IMRT in either a definitive or postoperative setting were prospectively enrolled. Target volume and organs at risk including intestinal cavity (IC) were delineated in every patient by a single physician. The IC volume that received a 10-50 Gy dose at 5-Gy intervals (V10-V50) and the percentage of irradiated volume as a fraction of total IC volume were calculated. Plasma citrulline levels, as an objective biological marker, were checked at three time points: baseline and after exposure to 30 Gy and 60 Gy.
Results: Of the 41 patients, only six experienced grade 1 acute intestinal toxicity. Although all dose-volume parameters were significantly worse following WP than SF IMRT, there was no statistically significant relationship between these dosimetric parameters and clinical symptoms. Plasma citrulline levels did not show a serial decrease by radiotherapy volume difference (WP versus SF) and were not relevant to the irradiated doses.
Conclusion: Given that WP had comparable acute intestinal toxicities to those associated with SF, WP IMRT appears to be a feasible approach for the treatment of prostate cancer despite dosimetric disadvantages.

• 出版日期2016