Dataset Information

Predictors for late genitourinary toxicity in men receiving radiotherapy for high-risk prostate cancer using planned and accumulated dose.

ABSTRACT:

Background and purpose

Significant deviations between bladder dose planned (D_P) and dose accumulated (D_A) have been reported in patients receiving radiotherapy for prostate cancer. This study aimed to construct multivariate analysis (MVA) models to predict the risk of late genitourinary (GU) toxicity with clinical and D_P or D_A as dose-volume (DV) variables.

Materials and methods

Bladder D_A obtained from 150 patients were compared with D_P. MVA models were built from significant clinical and DV variables (p < 0.05) at univariate analysis. Previously developed dose-based-region-of-interest (DB-ROI) metrics using expanded ring structures from the prostate were included. Goodness-of-fit test and calibration plots were generated to determine model performance. Internal validation was accomplished using Bootstrapping.

Results

Intermediate-high D_A (V_{30-65 Gy} and DB-ROI-20-50 mm) for bladder increased compared to D_P. However, at the very high dose region, D_A (D_{0.003 cc}, V_{75 Gy,} and DB-ROI-5-10 mm) were significantly lower. In MVA, single variable models were generated with odds ratio (OR) < 1. DB-ROI-50 mm was predictive of Grade ≥ 1 GU toxicity for D_A and D_P (D_A and D_P; OR: 0.96, p: 0.04) and achieved an area under the receiver operating curve (AUC) of > 0.6. Prostate volume (OR: 0.87, p: 0.01) was significant in predicting Grade 2 GU toxicity with a high AUC of 0.81.

Conclusions

Higher D_A (V_{30-65 Gy}) received by the bladder were not translated to higher late GU toxicity. DB-ROIs demonstrated higher predictive power than standard DV metrics in associating Grade ≥ 1 toxicity. Smaller prostate volumes have a minor protective effect on late Grade 2 GU toxicity.

SUBMITTER: Li Kuan Ong A

PROVIDER: S-EPMC9932727 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

Predictors for late genitourinary toxicity in men receiving radiotherapy for high-risk prostate cancer using planned and accumulated dose.

Li Kuan Ong Ashley A Knight Kellie K Panettieri Vanessa V Dimmock Mathew M Kit Loong Tuan Jeffrey J Qi Tan Hong H Wright Caroline C

Physics and imaging in radiation oncology 20230101

<h4>Background and purpose</h4>Significant deviations between bladder dose planned (D<sub>P</sub>) and dose accumulated (D<sub>A</sub>) have been reported in patients receiving radiotherapy for prostate cancer. This study aimed to construct multivariate analysis (MVA) models to predict the risk of late genitourinary (GU) toxicity with clinical and D<sub>P</sub> or D<sub>A</sub> as dose-volume (DV) variables.<h4>Materials and methods</h4>Bladder D<sub>A</sub> obtained from 150 patients were compa ...[more]

PMID: 36817981

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Project description:Highlights • Interfractional variations in organs at risk were observed in prostate radiotherapy.• Rectal accumulated dose was significantly higher at the intermediate-high dose region.• Rectal planned dose was significantly higher at the very high dose region.• Dose>78.2 Gy to 0.03 cc of rectum was predictive of late Grade 2 toxicity.• Patient age>72 years was predictive of late Grade 2 rectal toxicity. 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.

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Dataset Information

Predictors for late genitourinary toxicity in men receiving radiotherapy for high-risk prostate cancer using planned and accumulated dose.

Background and purpose

Materials and methods

Results

Conclusions

Publications

Predictors for late genitourinary toxicity in men receiving radiotherapy for high-risk prostate cancer using planned and accumulated dose.

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