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Dose-volume analysis of planned versus accumulated dose as a predictor for late gastrointestinal toxicity in men receiving radiotherapy for high-risk prostate cancer.

Ong, ALK; Knight, K; Panettieri, V; Dimmock, M; Tuan, JKL; Tan, HQ; Wright, C

Dose-volume analysis of planned versus accumulated dose as a predictor for late gastrointestinal toxicity in men receiving radiotherapy for high-risk prostate cancer. Thumbnail


Authors

ALK Ong

K Knight

V Panettieri

JKL Tuan

HQ Tan

C Wright



Abstract

Background and purpose: Significant dose deviations have been reported between planned (DP) and accumulated (DA) dose in prostate radiotherapy. This study aimed to develop multivariate analysis (MVA) models associating Grade 1 and 2 gastrointestinal (GI) toxicity with clinical and DP or DA dosimetric variables separately. Materials and methods: Dose volume (DV) metrics were compared between DA and DP for 150 high-risk prostate cancer patients. MV models were generated from significant clinical and dosimetric variables (p < 0.05) at univariate level. Dose-based-region of interest (DB-ROI) metrics were included. Model performance was measured, and additional subgroup analysis were performed. Results: Rectal DA demonstrated a higher intermediate-high dose (V30-65 Gy and DB-ROI at 15-50 mm) compared to DP. Conversely, at the very high dose region, rectal DA (V75 Gy and DB-ROI at 5-10 mm) were significantly lower. In MVA, rectal DB-ROI at 10 mm was predictive for Grade = 1 GI toxicity for DA and DP. Age, rectal DA for D0.03 cc, and rectal DP for DB-ROI 10 mm were predictors for Grade 2 GI toxicity. Subgroup analysis revealed that patients = 72 years old and a rectal DA of = 78.2 Gy were highly predictive of Grade 2 GI toxicity. Conclusions: The dosimetric impact of a higher dose rectal dose in DA due to volumetric changes was minimal and was not predictive of detrimental clinical toxicity apart from rectal D0.03 cc = 78.2 Gy for Grade 2 GI toxicity. The use of the DB-ROI method can provide equivalent predictive power as the DV method in toxicity prediction.

Acceptance Date Jul 6, 2022
Publication Date Jul 16, 2022
Publicly Available Date Mar 28, 2024
Journal Physics and Imaging in Radiation Oncology
Print ISSN 2405-6316
Pages 97 - 102
DOI https://doi.org/10.1016/j.phro.2022.07.001
Keywords Accumulated dose; Predictive model; Gastrointestinal toxicity; High-risk prostate; Volumetric image-guidance
Publisher URL https://www.sciencedirect.com/science/article/pii/S2405631622000641

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