Evidence map›Paper›PMID 30902559›Full record

Trial reportClinical oncology (Royal College of Radiologists (Great Britain))2019

Dosimetry and Gastrointestinal Toxicity Relationships in a Phase II Trial of Pelvic Lymph Node Radiotherapy in Advanced Localised Prostate Cancer.

M R Ferreira, K Thomas, L Truelove, A Khan, C Parker, D P Dearnaley, S Gulliford

Open access · hybridAbstract readClinical Trial, Phase II
In one paragraph

Trial report in Clinical oncology (Royal College of Radiologists (Great Britain)), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Review
  3. Effect of patient thickness on acute gastrointestinal toxicities following radiotherapy for prostate cancer.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2021
    Article
  4. Heuristic estimation of the α/β ratio for a cohort of Mexican patients with prostate cancer treated with external radiotherapy techniques.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

M R FerreiraInstitute of Cancer Research, London, UK; Royal Marsden NHS Foundation Trust, London, UK; Guys and St Thomas NHS Foundation Trust, UK; King's College London, UK. Electronic address: Miguel.ReisFerreira@icr.ac.uk.
K ThomasRoyal Marsden NHS Foundation Trust, London, UK.
L TrueloveInstitute of Cancer Research, London, UK; Royal Marsden NHS Foundation Trust, London, UK.
A KhanInstitute of Cancer Research, London, UK; Royal Marsden NHS Foundation Trust, London, UK.
C ParkerInstitute of Cancer Research, London, UK; Royal Marsden NHS Foundation Trust, London, UK.
D P DearnaleyInstitute of Cancer Research, London, UK; Royal Marsden NHS Foundation Trust, London, UK.
S GullifordInstitute of Cancer Research, London, UK; University College London Hospitals NHS Foundation Trust, London, UK.
Royal Marsden NHS Foundation Trust · GBUniversity College London Hospitals NHS Foundation Trust · GB

Funding

Cancer Research UK 10588Cancer Research UK 12518Cancer Research UK C1491/A15955Cancer Research UK C1491/A9895Cancer Research UK C8262/A7253Cancer Research UK SP2312/021Department of Health
6 · The paper itself

Abstract

aimsPelvic lymph node (PLN) radiotherapy for high-risk prostate cancer is limited by late gastrointestinal toxicity. Application of rectal and bowel constraints may reduce risks of side-effects. We evaluated associations between intensity-modulated radiotherapy (IMRT) dose-volume data and long-term gastrointestinal toxicity. MATERIALS AND

methodsData from a single-centre dose-escalation trial of PLN-IMRT were analysed, including conventionally fractionated (CFRT) and hypofractionated (HFRT) radiotherapy schedules. Associations between volumes of rectum and bowel receiving specified doses and clinician- and patient-reported toxicity outcomes were investigated independently. A metric, δ median (δM), was defined as the difference in the medians of a volume between groups with and without toxicity at a specified dose and was used to test for statistically significant differences.

resultsConstraints were respected in most patients and, when exceeded, led to higher rates of gastrointestinal toxicity. Biologically relevant associations between rectum dose-points and toxicity were more numerous with both mild and moderate toxicity thresholds, but statistical significance was limited after correction for false discovery rate. Rectal V50Gy (CFRT) associated with grade 2+ bleeding; bowel V43Gy and V47 (HFRT/4 days/week schedule) associated with patient-reported loose stools and diarrhoea, respectively. Further investigation showed that CFRT patients with rectal bleeding had a mean rectal V50Gy above the treatment planning constraint.

conclusionsWhen dose-volume parameters are kept below tight constraints, toxicity is low. Residual dosimetry loses much of its predictive power for gastrointestinal toxicity in the setting of PLN-IMRT for prostate cancer. We have benchmarked dose-volume constraints for safely delivering PLN-IMRT using CFRT or HFRT.

Indexed as

AgedAged, 80 and overHumansIntestine, LargeLymphatic MetastasisLymph NodesMaleMiddle AgedPelvisProstatic NeoplasmsRadiometryRadiotherapy, Intensity-ModulatedRectumDose-volume constraintsdosimetrygastrointestinal side-effectsIMRTpelvic lymph nodesprostate cancer

Identifiers

PMID30902559
PMCPMC6505687
OpenAlexW2924004300

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.