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International Journal of Radiation Oncology Biology Physics 2000-Apr

Acute toxicity of three-dimensional conformal radiotherapy in prostate cancer patients eligible for implant monotherapy.

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R H Chou
R B Wilder
M Ji
J K Ryu
B R Leigh
J D Earle
R L Doggett
H D Kubo
M Roach
R W deVere White

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OBJECTIVE

To assess the acute toxicity of three-dimensional conformal radiotherapy (3D-CRT) in prostate cancer patients eligible for implant monotherapy.

METHODS

Between December 1991 and June 1998, 198 prostate cancer patients were treated with 3D-CRT at the University of California Davis Medical Center. Fifty-two of these patients had a prostate-specific antigen (PSA) level

RESULTS

Overall, 3D-CRT was well-tolerated: 29% of patients experienced RTOG Grade 1 and 27% experienced Grade 2 acute lower gastrointestinal (GI) toxicity. Forty percent and 33% of patients experienced Grade 1 and 2 acute genitourinary (GU) toxicity, respectively. As expected, more acute morbidity, especially GI, was observed with a larger clinical target volume (prostate and seminal vesicles versus prostate only; p = 0. 05). Neoadjuvant hormonal therapy did not increase the incidence or severity of radiation-induced side effects. No acute toxicity >/= Grade 3, e.g., hourly nocturia, gross hematuria, diarrhea requiring parenteral support, narcotics for pain control, or catheterization for acute urinary retention, was observed.

CONCLUSIONS

Although relatively high doses of radiation are delivered to prostate cancers with 3D-CRT compared with conventional radiotherapy, 3D-CRT is surprisingly well-tolerated. No patients in the cohort eligible for implant monotherapy experienced acute toxicity >/= Grade 3.

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