ArticleAdvances in radiation oncology2025
Dosimetric Clues to Addressing Urinary Toxicity Following Stereotactic Prostate Radiation Therapy.
Article in Advances in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- An X-ray and γ-ray combination strategy to exploit steep dose gradients for improved prostate cancer radiotherapy: A dosimetric comparison of Taichi Pro and Halcyon.Journal of applied clinical medical physics · 2026Article
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10 authors.
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Abstract
Purpose: Delayed genitourinary (GU) toxicity is reported following definitive stereotactic body radiation therapy (SBRT) for prostate cancer in 15% to 30% of patients. The purpose of this study is to investigate whether there is a relationship between radiation dose to the bladder and urethra and GU toxicity grade ≥ 2 (National Cancer Institute Common Terminology Criteria for Adverse Events 4.0) in patients treated with SBRT. Methods and Materials: PROstate Multicenter External beam radioTHErapy Using Stereotactic boost was a phase 2 multicenter trial exploring an SBRT boost of 19 to 20 Gy in 2 fractions to the prostate combined with fractionated external beam radiation therapy as a virtual high-dose-rate brachytherapy boost for patients with prostate cancer. Several bladder and urethral constraints were mandated prospectively. Bladder and the urethral planning organ at risk volume (PRV) dosimetry was correlated with physician-reported GU toxicity for patients ≥ 6 months following SBRT. An association between prior transurethral resection of the prostate (TURP) and urinary toxicity was also examined. Univariant and multivariate analyses were performed. Results: Of the 151 patients, 87 had complete dosimetric data, and these patients were included in this analysis. In this cohort, 19.5% experienced grade ≥ 2 GU toxicity more than 6 months after stereotactic radiation therapy. On univariate analysis, prostatic urethral length, urethral PRV volume, bladder D2 cc, D5 cc, D10 cc, D15 cc, and bladder V8 were predictive of GU toxicity (all Conclusions: Prostate SBRT delivered as a virtual high-dose-rate boost is well tolerated overall. However, delayed GU toxicity is experienced by a significant minority of patients. Additional bladder constraints including D10 cc < 17 Gy and D15 cc < 15 Gy may further reduce the risk of delayed GU toxicity. Prior TURP may be a plausible additional risk factor.
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