Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-11T05:29:53.215Z Has data issue: false hasContentIssue false
  • English
  • Français

Late rectal bleeding after volumetric-modulated arc therapy for localised prostatic cancer

Published online by Cambridge University Press:  26 October 2018

Yutaka Naoi ,
Kana Yamada ,
Chie Kurokawa ,
Hiroaki Kunogi ,
Yoshiro Sakamoto  and
Keisuke Sasai
Yutaka Naoi*
Affiliation:
Department of Radiation Oncology
Kana Yamada
Affiliation:
Department of Radiation Oncology
Chie Kurokawa
Affiliation:
Department of Radiation Oncology
Hiroaki Kunogi
Affiliation:
Department of Radiation Oncology
Yoshiro Sakamoto
Affiliation:
Department of Urology, Juntendo University Nerima Hospital, Japan
Keisuke Sasai
Affiliation:
Department of Radiation Oncology, Juntendo University, Japan
*
Author for correspondence: Yutaka Naoi, Department of Radiation Oncology, Juntendo University Nerima Hospital, 3-1-10 Takanodai Nerima-ku, Tokyo 177-8521, Japan. Tel: 813-5923-3111. Fax: 813-5923-3237. E-mail: naoi@alpha.ocn.ne.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim

Late adverse effects following radiation therapy for prostate cancer involve the urinary and lower gastrointestinal tracts, with continuous rectal bleeding being the most serious issue. We focused on late adverse effects, particularly rectal bleeding after volumetric-modulated arc therapy (VMAT), for patients with locally advanced prostate cancer.

Materials and Methods

Seventy-three patients with localized prostate cancer were treated with radiation therapy using VMAT with an image-guided radiation therapy system. Patient age at the start of irradiation ranged from 54 to 81 years (median, 71 years). The follow-up period ranged from 23 to 87 months (median, 57 months). The prescribed total irradiation dose was 76 Gy in 38 fractions.

Results

Late rectal bleeding was observed in 14 (19%) patients, with nine (12.3%), four (5.5%), and one (1.4%) being classified as grades 1, 2, and 3, respectively. One grade 3 patient with rectal bleeding had severe diabetes and was administered intravenous warfarin for cardiomyopathy.

Findings

VMAT may provide better accuracy and involve fewer time constraints for patients compared with other intensity-modulated radiation therapy (IMRT) methods. The incidence of late rectal bleeding in VMAT is almost equivalent to that of other IMRT methods.

Keywords

IGRTIMRTlate rectal bleedingprostate ca.VMAT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 18 , Issue 2 , June 2019 , pp. 165 - 168
Check for updates
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Cite this article: Naoi Y, Yamada K, Kurokawa C, Kunogi H, Sakamoto Y, Sasai K. (2019) Late rectal bleeding after volumetric-modulated arc therapy for localised prostatic cancer. Journal of Radiotherapy in Practice18: 165–168. doi: 10.1017/S1460396918000560

References

1. Wolff, D, Stieler, F, Welzel, G et al. Volumetric modulated arc therapy (VMAT) vs. serial tomotherapy, step-and-shoot IMRT and 3D-conformal RT for treatment of prostate cancer. Radiother Oncol 2009; 93: 226–233.Google Scholar
2. Tsutsumi, S, Hosono, M. N, Tatsumi, D et al. Delivery parameter variations and early clinical outcomes of volumetric modulated arc therapy for 31 prostate cancer patients: an intercomparison of three treatment planning systems. Scient World J 2013; Article ID 289809, 7. DOI: 10.1155/2013/289809.10.1155/2013/289809Google Scholar
3. Tambas, M, Agaoglu, F, Iribas, A et al. Conventionally fractionationed volumetric arc therapy versus hypofractionated stereotactic body radiotherapy: quality of life, side effects, and prostate-specific antigen kinetics in localized prostate cancer. 3. Value Health Reg Issues 2016; 10: 91–99 DOI: 10.1016/j.vhri.2016.08.001. Epub 2016 Oct 6.Google Scholar
4. Palma, D, Vollans, E, James, K et al. Volumetric modulated arc therapy for delivery of prostate radiotherapy: comparison with intensity-modulated radiotherapy and three-dimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys 2008; 72: 996–1001 DOI: 10.1016/j.ijrobp.2008.02.047. Epub 2008 May.10.1016/j.ijrobp.2008.02.047Google Scholar
5. Takemoto, S, Shibamoto, Y, Ayakawa, S et al. Treatment and prognosis of patients with late rectal bleeding after intensity-modulated radiation therapy for prostate cancer. Radiat Oncol 2012; 7: 87.10.1186/1748-717X-7-87Google Scholar
6. Budaus, L, Bolla, M, Bossi, A et al. Functional outcomes and complications following radiation therapy for prostate cancer: a critical analysis of the literature. Eur . Urol 2012; 61: 112–127.Google Scholar
7. Michalski, J. RTOG 0126 (10/18/04) A phase III randomized study of high dose 3DCRT/IMRT versus standard dose 3DCRT/IMRT in patients treated for localized prostate cancer. https://www.rtog.org/ClinicalTrials/ProtocolTable/StudyDetails.aspx?study=0126. Accessed on 3rd April 2009.Google Scholar
8. Stokkevåg, C. H, Engeseth, G. M, Hysing, L. B, Ytre-Hauge, K. S, Ekanger, C, Muren, L. P. Risk of radiation-induced secondary rectal and bladder cancer following radiotherapy of prostate cancer. Acta Oncol 2015; 54: 1317–1325 DOI: 10.3109/0284186X.2015.1061691.Google Scholar
9. Zelefsky, M. J, Fuks, Z, Hunt, M et al. High-dose intensity modulated radiation therapy for prostate cancer: early toxicity and biochemical outcome in 772 patients. Int J Radiat Oncol Biol Phys 2002; 53: 1111–1116.Google Scholar
10. Vora, S. A, Wong, W. W, Schild, S. E, Ezzell, G. A, Halyard, M. Y. Analysis of biochemical control and prognostic factors in patients treated with either low-dose three-dimensional conformal radiation therapy or high-dose intensity-modulated radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys 2007; 68: 1053–1058 DOI: 10.1016/j.ijrobp.2007.01.043.Google Scholar
11. Zapatero, A, Guerrero, A, Maldonado, X et al. High-dose radiotherapy with short-term or long-term androgen deprivation in localised prostate cancer (DART01/05 GICOR): a randomised, controlled. Lancet Oncol 2015; 16: 320–327.10.1016/S1470-2045(15)70045-8Google Scholar
12. Wortel, R. C, Incrocci, L, Pos, F. J et al. Late side effects after image guided intensity modulated radiation therapy compared to 3D-conformal radiation therapy for prostate cancer: results from 2 prospective cohorts. Int J Radiat Oncol Biol Phys 2016; 95: 681–689.Google Scholar
13. Okonogi, N, Katoh, H, Kawamura, H et al. Clinical outcomes of helical tomotherapy for super-elderly patients with localized and locally advanced prostate cancer: comparison with patients under 80 years of age. J Radiat Res 2015; 15: 889–896 doi: DOI: 10.1093/jrr/rrv040.Google Scholar
14. Mizowaki, T, Norihisa, Y, Takayama, K et al. Long-term outcomes of intensity-modulated radiation therapy combined with neoadjuvant androgen deprivation therapy under an early salvage policy for patients with T3-T4N0M0 prostate cancer. Int J Clin Oncol 2016; 28: 148–155 DOI: 10.1007/s10147-015-0867-7.10.1007/s10147-015-0867-7Google Scholar
15. Dearnaley, D, Syndikus, I, Mossop, H et al. Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial. Lancet Oncol 2016; 17: 1047–1060 DOI: 10.1016/S1470-2045(16)30102-4.Google Scholar
16. Katahira-Suzuki, R, Omura, M, Takano, S et al. Clinical and dosimetric predictors of late rectal bleeding of prostate cancer after TomoTherapy intensity modulated radiation therapy. J Med Radiat Sci 2017; 64: 172–179. Google Scholar
17. Someya, M, Hori, M, Tateoka, K et al. Results and DVH analysis of late rectal bleeding in patients treated with 3D-CRT or IMRT for localized prostate cancer. J Radiat Res 2015; 56: 122–127.Google Scholar
18. Wolff, D, Stieler, F, Welzel, G et al. Volumetric modulated arc therapy (VMAT) vs. serial tomotherapy, step-and-shoot IMRT and 3D-conformal RT for treatment of prostate cancer. Radiother Oncol 2009; 93: 226–233 DOI: 10.1016/j.radonc.2009.08.011.Google Scholar
19. Inokuchi, H, Mizowaki, T, Norihisa, Y et al. Clinical effect of multileaf collimator width on the incidence of late rectal bleeding after high‑dose intensity‑modulated radiotherapy for localized prostate carcinoma. Int J Clin Oncol 2016; 21: 156–161 DOI: 10.1007/s10147-015-0873-9.Google Scholar
20. Groh, B. A, Siewerdsen, J. H, Drake, D. G, Wong, J. W, Jaffray, D. A. A performance comparison of flat-panel imager-based MV and kV cone-beam. CT Med Phys 2002; 29: 967–975.Google Scholar
21. Elith, C, Dempsey, S. E, Findlay, N, Warren-Forward, H. M. An introduction to the intensity-modulated radiation therapy(IMRT) techniques, tomotherapy, and VMAT. J Med Imag Radiat Sci 2011; 42: 37–43 DOI: 10.1016/j.jmir.2010.11.005.Google Scholar
22. Rao, M, Yang, W, Chen, F et al. Comparison of Elekta VMAT with helical tomotherapy and fixed field IMRT: plan quality, delivery efficiency and accuracy. Med Phys 2010; 37: 1350–1359.Google Scholar
23. Tanaka, H, Yamaguchi, T, Hachiya, K et al. Treatment outcomes and late toxicities of intensity-modulated radiation therapy for 1091 Japanese patients with localized prostate cancer. Rep Pract Oncol Radiother 2018; 23: 28–33 DOI: 10.1016/j.rpor.2017.11.002.10.1016/j.rpor.2017.11.002Google Scholar
24. Zelefsky, M. J, Kollmeier, M, Cox, B et al. Improved clinical outcomes with high-dose image guided radiotherapy compared with non-IGRT for the treatment of clinically localized prostate cancer. Int J Radiat Oncol Biol Phys 2012; 84: 125–129 DOI: 10.1016/j.ijrobp.2011.11.047.10.1016/j.ijrobp.2011.11.047Google Scholar