The contribution of the cone beam Kv CT (CBKvCT) to the reduction in toxicity of prostate cancer treatment with external 3D radiotherapy

• Published in: Clinical & translational oncology Vol. 14; no. 11; pp. 853 - 863
• Main Authors: Conde-Moreno, Antonio José, Ferrer-Albiach, Carlos, Zabaleta-Meri, Mercedes, Juan-Senabre, Xavi J., Santos-Serra, Agustín
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.11.2012
• Subjects: Cone-Beam Computed Tomography; Humans; Male; Medicine; Medicine & Public Health; Oncology; Proctitis - diagnostic imaging; Proctitis - etiology; Proctitis - pathology; Prostatic Neoplasms - pathology; Prostatic Neoplasms - radiotherapy; Radiation Injuries - diagnostic imaging; Radiation Injuries - etiology; Radiation Injuries - pathology; Radiotherapy Dosage; Radiotherapy, Conformal; Radiotherapy, Image-Guided - adverse effects; Research Article; Retrospective Studies; Urinary Bladder - pathology; Image-guided radiotherapy (IGRT); Cone beam KvCT (CBKvCT); 3D External Radiotherapy (3DRT); Prostate cancer
• ISSN: 1699-048X; 1699-3055
• DOI: 10.1007/s12094-012-0871-6

Objective Show that verification through cone beam Kv CT (CBKvCT) in a series of patients treated with 3D external radiotherapy (3DRT) for prostate cancer (PC) is related to a reduction in acute and late toxicity levels. Materials and method A retrospective, non-randomized study of two homogeneous groups of patients treated between 2005 and 2008, 46 were verified using electronic portal devices (EPIDs) and 48 through CBKvCT. They received 3DRT for localized PC (T1-T3N0M0) and were prescribed the same doses. Treatment was simulated and planned with the same criteria with the same equipment with a median follow-up time of 24 months (12–54 months). Urinary and gastrointestinal toxicity was determined using Common Toxicity Criteria scale, version 4 and RTOG scales. Statistical analysis of data was performed where p  < 0.005 being significative. Results and discussion With an overall median follow-up time of 24 months, the levels of proctitis were, respectively, 19.56, 15.21 and 15.2 % in the first group, compared with 4.17, 2.08 and 8.33 % in the second. Statistically, less total and late proctitis, late rectal bleeding, anal fissure, total and acute haematuria, total and acute urinary frequency and total urinary incontinence was observed. No statistically significant evidence of a lowering in toxicity neither in terms of acute and late dysuria nor of a relationship to the TNM, Gleason or PSA or in the grade of stability. Conclusion Verification through CBKvCT in this series is associated with a statistically significant lowering toxicity. This justifies its use. Greater monitoring would be necessary to assess the impact of verification at the level of biochemical control.