scholarly journals Evaluation of Mediators Associated with the Inflammatory Response in Prostate Cancer Patients Undergoing Radiotherapy

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Nice Bedini ◽  
Alessandro Cicchetti ◽  
Federica Palorini ◽  
Tiziana Magnani ◽  
Valentina Zuco ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Inflammatory Response ◽  
Cancer Patients ◽  
Late Toxicity ◽  
Tnf Alpha ◽  
Rectal Toxicity ◽  
Feasibility Evaluation ◽  
Prostate Cancer Radiotherapy ◽  
Late Rectal Toxicity ◽  
Inflammatory Molecules

A recent “hot topic” in prostate cancer radiotherapy is the observed association between acute/late rectal toxicity and the presence of abdominal surgery before radiotherapy. The exact mechanism is unclear. Our working hypothesis was that a previous surgery may influence plasma level of inflammatory molecules and this might result in enhanced radiosensitivity. We here present results on the feasibility of monitoring the expression of inflammatory molecules during radiotherapy. Plasma levels of a panel of soluble mediators associated with the inflammatory response were measured in prostate cancer patients undergoing radical radiotherapy. We measured 3 cytokines (IL-1b, IL-6, and TNF alpha), 2 chemokines (CCL2 and CXCL8), and the long pentraxin PTX3. 20 patients were enrolled in this feasibility evaluation. All patients were treated with IMRT at 78 Gy. 3/20 patients reported grade 2 acute rectal toxicity, while 4/20 were scored as grade 2 late toxicity. CCL2 was the most interesting marker showing significant increase during and after radiotherapy. CCL2 levels at radiotherapy end could be modelled using linear regression including basal CCL2, age, surgery, hypertension, and use of anticoagulants. The 4 patients with late toxicity had CCL2 values at radiotherapy end above the median value. This trial is registered with ISRCTN64979094.

scholarly journals EP-1348: Endoscopic evaluation of late rectal toxicity after radiotherapy in 597 prostate cancer patients

2016 ◽  
Vol 119 ◽  
pp. S630
Author(s):  
M. Nuzzo ◽  
G. Macchia ◽  
S. Cilla ◽  
M. Ingrosso ◽  
C. Digesù ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Rectal Toxicity ◽  
Endoscopic Evaluation ◽  
Late Rectal Toxicity

Use of the slope of the DVH curve for predicting late rectal toxicity in IMRT for patients with localized prostate cancer.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 230-230
Author(s):  
Gilles Crehange ◽  
Paul M Walker ◽  
Mélanie Gauthier ◽  
Céline Mirjolet-Didelot ◽  
Aurelie Petitfils ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Rectal Wall ◽  
Univariate Analysis ◽  
Late Toxicity ◽  
Rectal Toxicity ◽  
Rectosigmoid Junction ◽  
Dose Volume ◽  
Grade 3 ◽  
Late Rectal Toxicity ◽  
Ischial Tuberosities

230 Background: Dose volume specific endpoints (DVSE) have been demonstrated to be reliable and reproducible for predicting late toxicity with conformal 3D-RT. New highly sophisticated delivery techniques such as IGRT or IMRT or combined IG-IMRT can spare rectum more efficiently while substantially increasing the delivered dose to the prostate. The purpose of this study is to investigate whether the slope of the DVH curve could predict late rectal toxicity more accurately than DVSE in prostate cancer (PCa) patients. Methods: Charts from164 men with complete DVH data who had a localized PCa were treated with exclusive IG-IMRT. The rectum was defined as a cylindrical structure around the outer rectal wall and contoured from the ischial tuberosities to the rectosigmoid junction. A set of DVSE were registered (V75, V70, V60). Four distinct DVH groupings were defined for each DVSE: [0–5%], ]5–10%], ]10–15%] and ]15–20%]. In parallel, we decided to calculate the slope of the DVH curves encompassing the 3 DVSE: 60Gy, 70Gy and 75Gy. The median dose prescribed to the prostate was 78Gy (min. 74Gy – max. 78Gy). Late toxicity was retrospectively scored according to the CTC v.3.0 morbidity grading scales. Univariate analysis using a logistic regression was performed to determine the relationship between DVSE, the slope 60-75Gy and the appearance of any late rectal toxicity (grade ≥ 1). Results: With a median follow-up of 38.3 months [5.25 – 87.3], the rates of grade (G) 1, G2 gastrointestinal toxicity were 20.4%, 2.4%. No grade 3 or 4 occurred. For the rectum, the average Dmean, D98, V75, V70 and V60 were 39.9 Gy [25.7–61.1], 8.9Gy [1.0–38.8], 1.1Gy [0.0–33.3], 6.0 Gy [0.0–44.0] and 19.0 Gy [1.0–70.0]. DVH groupings for V75, V70 and V60 were not predictive of any G≥1 late rectal toxicity (p= 0.836, p= 0.580 and p= 0.152, respectively). The slope 60-75Gy was significantly correlated with late rectal toxicity ≥ G1 (OR= 0.55, [CI95%: 0.33–0.92], p= 0.024). Conclusions: DVSE could be irrelevant with IG-IMRT, thus jeopardizing the clinical benefit of dose escalation. The slope of the curve predicts more accurately late toxicity when attempting to optimize dose distribution.

Reporting Late Rectal Toxicity in Prostate Cancer Patients Treated With Curative Radiation Treatment

2008 ◽  
Vol 72 (3) ◽  
pp. 777-781 ◽  
Author(s):  
Sergio L. Faria ◽  
Luis Souhami ◽  
Bosede Joshua ◽  
Te Vuong ◽  
Carolyn R. Freeman
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Radiation Treatment ◽  
Rectal Toxicity ◽  
Late Rectal Toxicity

scholarly journals Is an Endorectal Balloon Beneficial for Rectal Sparing After Spacer Implantation in Prostate Cancer Patients Treated With Hypofractionated Intensity-modulated Proton Beam Therapy? A Dosimetric and Radiobiological Comparison Study

2021 ◽  
Author(s):  
Dalia Ahmad Khalil ◽  
Jörg Wulff ◽  
Danny Jazmati ◽  
Dirk Geismar ◽  
Christian Bäumer ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Seminal Vesicle ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Rectal Toxicity ◽  
P Values ◽  
Intensity Modulated ◽  
Late Rectal Toxicity ◽  
Dose Levels

Abstract BackgroundThe aim of this study is to examine the dosimetric influence of endorectal balloons (ERB) in rectal sparing in prostate cancer patients with implanted hydrogel rectum spacers treated with dose escalated/hypofractionated intensity modulated proton beam therapy (IMPT). MethodsTen patients with localised prostate cancer included in the ProRegPros study and treated at our centre were invastigated in this study. All patients underwent a placement of hydrogel rectum spacers before planning. Two planning CTs (with and without 120 cm3 fluid-filled ERB) were acquired for each patient. Dose prescription was set according to the used simultaneous integrated boost strategy with 72 Gray (Gy)/2.4 Gy/5 x weekly to prostate+1 cm of the seminal vesicle, and 60 Gy/2 Gy/5 x weekly to prostate+2 cm of the seminal vesicle. Planning with two lateral-opposed IMPT beams was performed in both CTs. Rectal dosimetry values including dose-volume statistics and normal tissue complication probability (NTCP) in both plans were compared (non-ERB plans vs. ERB plans).ResultsFor ERB plans compared to non-ERB, the reductions were 8.51 ± 5.25 Gy (RBE) (p= 0.000) and 15.76 ± 11.11Gy (P= 0.001) for the mean and the median rectal dose, respectively. No significant reductions in rectal volumes receiving high dose levels were found. The use of ERB resulted in significant reduction in rectal volume receiving 50 Gy (RBE), 40 Gy (RBE), 30 Gy (RBE), 20 Gy (RBE), and 10 Gy (RBE) with P values of 0.034, 0.008, 0.003, 0.001, and 0.001, respectively. For the anterior rectum, no differences between ERB and non-ERB plans were observed. For the posterior rectum, ERB reduced rectal volumes received 30 Gy (RBE), 20 Gy (RBE), and 10 Gy (RBE) with P values of 0.019, 0.003, and 0.001, respectively. No significant reductions in mean or median rectal toxicity (Late rectal bleeding ≥2, necrosis/stenosis, and Late rectal toxicity ≥ 3) were observed when using the ERB according to NTCP models.ConclusionThe ERB reduced rectal volumes exposed to intermediate/low dose levels. However, no significant reduction in rectal volumes receiving high/intermediate doses could be observed. No benefit but also no disadvantage of the ERB for late rectal toxicity was found according to available NTCP models.

P024 Late rectal toxicity after RT for prostate cancer: Case of patients with moderate/severe basal symptoms

2014 ◽  
Vol 13 (5) ◽  
pp. 117
Author(s):  
G. Fellin ◽  
T. Rancati ◽  
V. Vavassori ◽  
C. Fiorino ◽  
R. Valdagni
Keyword(s):  
Prostate Cancer ◽  
Cancer Case ◽  
Prostate Cancer Case ◽  
Rectal Toxicity ◽  
Late Rectal Toxicity
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