ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2019
Tolerance doses for late adverse events after hypofractionated radiotherapy for prostate cancer on trial NRG Oncology/RTOG 0415.
Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 24 citations in OpenAlex.
- Estimates of Alpha/Beta (α/β) Ratios for Individual Late Rectal Toxicity Endpoints: An Analysis of the CHHiP Trial.International journal of radiation oncology, biology, physics · 2021Trial
- Risk of genitourinary late effects after radiotherapy for prostate cancer associated with early changes in bladder shape.Physics and imaging in radiation oncology · 2025Article
- An exposure-safety analysis to support the dosage of the novel AKT inhibitor capivasertib.Cancer chemotherapy and pharmacology · 2025Article
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- Radiation technique and outcomes following moderately hypofractionated treatment of low risk prostate cancer: a secondary analysis of RTOG 0415.Prostate cancer and prostatic diseases · 2024Article
- Acute and long-term toxicity in primary hypofractionated external photon radiation therapy in patients with localized prostate cancer.World journal of urology · 2024Review
- Gastrointestinal Toxicity Prediction Not Influenced by Rectal Contour or Dose-Volume Histogram Definition.International journal of radiation oncology, biology, physics · 2023Article
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- Article
- Article
- Simulation study using the spots deletion technique in spot scanning proton beam therapy for prostate cancers.Molecular and clinical oncology · 2022Article
- Dosimetric impact of rectum and bladder anatomy and intrafractional prostate motion on hypofractionated prostate radiation therapy.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2021Article
- Distribution analysis of hydrogel spacer and evaluation of rectal dose reduction in Japanese prostate cancer patients undergoing stereotactic body radiation therapy.International journal of clinical oncology · 2021Article
- Efficacy and Prognostic Factors of Androgen Deprivation Therapy Combined with Radiation Therapy for Prostate Cancer.Evidence-based complementary and alternative medicine : eCAM · 2021Article
- Refinement & validation of rectal wall dose volume objectives for prostate hypofractionation in 20 fractions.Clinical and translational radiation oncology · 2020Article
- COVID-19: hypofractionation in the Radiation Oncology Department during the 'state of alarm': first 100 patients in a private hospital in Spain.Ecancermedicalscience · 2020Article
- Hypofractionated Radiotherapy for Localized Prostate Cancer: When and for Whom?Current urology reports · 2019Review
- A Ten-year-long Update on Radiation Proctitis Among Prostate Cancer Patients Treated With Curative External Beam Radiotherapy.In vivo (Athens, Greece)Review
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Authors and funding
21 authors at 15 institutions in 2 countries.
Funding
Abstract
PURPOSE/
objectiveHypofractionated radiotherapy (HRT) regimens for prostate cancer are emerging, but tolerance doses for late adverse events are scarce. The purpose of this study is to define dose-volume predictors for late gastrointestinal and genitourinary (GI and GU) toxicities after HRT in the multi-center NRG Oncology/RTOG 0415 low-risk prostate cancer trial (N = 521). MATERIAL/
methodsTreatment in the studied HRT arm was delivered as 70 Gy at 2.5 Gy/fraction with 3D-CRT/IMRT (N = 108/413). At a median follow-up of 5.9 years, the crude late ≥Grade 2 GI and GU toxicities were 19% and 29%, respectively. For modeling, the complete HRT cohort was randomly split into training and validation (70% and 30%; preserved toxicity rates). Within training, dose-response modeling was based on dose-volume cut-points (EQD2Gy; bladder/rectum: α/β = 6 Gy/3Gy), age, acute ≥Grade 2 toxicity, and treatment technique using univariate and multivariate logistic regression on bootstrapping (UVA and MVA). Candidate predictors were determined at p ≤ 0.05, and the selected MVA models were explored on validation where model generalizability was judged if the area under the receiver-operating curve in validation (AUC
resultsThree candidate predictors were suggested for late GI toxicity: the minimum dose to the hottest 5% rectal volume (D5%[Gy]), the absolute rectal volume <35 Gy, and acute GI toxicity (AUC = 0.59-0.63; p = 0.02-0.04). The two generalizable MVA models, i.e., D5%[Gy] with or without acute GI toxicity (AUC
conclusionLate GI toxicity, following moderate HRT for low-risk prostate cancer, increases with higher doses to small rectal volumes. This work provides quantitative evidence that limiting small rectal dose 'hotspots' in clinical practice of such HRT regimens is likely to further reduce the associated rates of GI toxicity.
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