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- W2373236543 abstract "Introduction: Lymph node metastasized (N1) prostate cancer (PC) patients may benefit from trimodality therapy i.e. radical prostatectomy (RP) with pelvic lymph node dissection (PLND) plus high-dose whole-pelvis radiotherapy (RT) and androgen deprivation therapy (ADT). We assess acute and early late RT-induced toxicity compared to patients receiving postoperative prostate-only RT.Materials and methods: Forty-eight N1-PC patients were treated with adjuvant (n=19) or salvage (n=29) intensity-modulated arc therapy and 2-3 years of ADT (median follow-up 12 months). Mean dose to the prostate bed and lymph node regions (including common, internal and external iliac vessels, obturator fossa and presacral nodes) was 76 Gy and 54 Gy respectively in 36-37 fractions. Patients were matched with 48 N0-PC patients receiving prostate-only RT following RP-PLND from 239 eligible patients. RT doses to the prostate bed were equivalent. Prospective end points are acute and late genito-urinary (GU) and gastro-intestinal (GI) toxicity. Late toxicity was restricted to patients with ≥12 months follow-up. An in-house developed toxicity scale was used based on RTOG/CTCAE/SOMA-LENT scales for GU and a modified RTOG scale for GI toxicity.Results: Patient and tumor characteristics did not differ significantly in both groups, except for follow-up (pelvic RT 17 ± 16,1 vs. prostate-only RT 43 ± 30,2 months; p<0.001) and ADT use (pelvic RT 98% vs. prostate-only RT 71%; p<0.001). Toxicity outcomes are presented in the table. While GU toxicity did not differ significantly, acute and late GI toxicity was higher in patients receiving pelvic RT compared to prostate-only RT (p≤0.007). In the pelvic RT group 59% of ≥grade 2 GU toxicity recuperated and 100% of ≥grade 2 GI toxicity. Two patients developed lymphedema. Conclusions: Postoperative high-dose pelvic RT plus ADT comes at the cost of a temporary increase in grade 2 GI toxicity." @default.
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- W2373236543 date "2013-01-01" @default.
- W2373236543 modified "2023-09-24" @default.
- W2373236543 title "Acute and late toxicity after postoperative high-dose pelvic radiotherapy and androgen deprivation for node positive prostate cancer patients: a powerful tool that should be handled with care?" @default.
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