Publication

Comparative toxicity outcomes of proton-beam therapy versus intensity-modulated radiotherapy for prostate cancer in the postoperative setting

Santos, P. M. G., Barsky, A. R., Hwang, W-T., Deville, C., Wang, X., Both, S., Bekelman, J. E., Christodouleas, J. P. & Vapiwala, N., 10-Sep-2019, In : Cancer. 16 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Santos, P. M. G., Barsky, A. R., Hwang, W-T., Deville, C., Wang, X., Both, S., ... Vapiwala, N. (2019). Comparative toxicity outcomes of proton-beam therapy versus intensity-modulated radiotherapy for prostate cancer in the postoperative setting. Cancer. https://doi.org/10.1002/cncr.32457

Author

Santos, Patricia Mae G. ; Barsky, Andrew R. ; Hwang, Wei-Ting ; Deville, Curtiland ; Wang, Xingmei ; Both, Stefan ; Bekelman, Justin E. ; Christodouleas, John P. ; Vapiwala, Neha. / Comparative toxicity outcomes of proton-beam therapy versus intensity-modulated radiotherapy for prostate cancer in the postoperative setting. In: Cancer. 2019.

Harvard

Santos, PMG, Barsky, AR, Hwang, W-T, Deville, C, Wang, X, Both, S, Bekelman, JE, Christodouleas, JP & Vapiwala, N 2019, 'Comparative toxicity outcomes of proton-beam therapy versus intensity-modulated radiotherapy for prostate cancer in the postoperative setting', Cancer. https://doi.org/10.1002/cncr.32457

Standard

Comparative toxicity outcomes of proton-beam therapy versus intensity-modulated radiotherapy for prostate cancer in the postoperative setting. / Santos, Patricia Mae G.; Barsky, Andrew R.; Hwang, Wei-Ting; Deville, Curtiland; Wang, Xingmei; Both, Stefan; Bekelman, Justin E.; Christodouleas, John P.; Vapiwala, Neha.

In: Cancer, 10.09.2019.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Santos PMG, Barsky AR, Hwang W-T, Deville C, Wang X, Both S et al. Comparative toxicity outcomes of proton-beam therapy versus intensity-modulated radiotherapy for prostate cancer in the postoperative setting. Cancer. 2019 Sep 10. https://doi.org/10.1002/cncr.32457


BibTeX

@article{6c88429a853e4b48bea2427e6f430e1b,
title = "Comparative toxicity outcomes of proton-beam therapy versus intensity-modulated radiotherapy for prostate cancer in the postoperative setting",
abstract = "Background Despite increasing utilization of proton-beam therapy (PBT) in the postprostatectomy setting, no data exist regarding toxicity outcomes relative to intensity-modulated radiotherapy (IMRT). The authors compared acute and late genitourinary (GU) and gastrointestinal (GI) toxicity outcomes in patients with prostate cancer (PC) who received treatment with postprostatectomy IMRT versus PBT. Methods With institutional review board approval, patients with PC who received adjuvant or salvage IMRT or PBT (70.2 gray with an endorectal balloon) after prostatectomy from 2009 through 2017 were reviewed. Factors including combined IMRT and PBT and/or concurrent malignancies prompted exclusion. A case-matched cohort analysis was performed using nearest-neighbor 3-to-1 matching by age and GU/GI disorder history. Logistic and Cox regressions were used to identify univariate and multivariate associations between toxicities and cohort/dosimetric characteristics. Toxicity-free survival (TFS) was assessed using the Kaplan-Meier method. Results Three hundred seven men (mean +/- SD age, 59.7 +/- 6.3 years; IMRT, n = 237; PBT, n = 70) were identified, generating 70 matched pairs. The median follow-up was 48.6 and 46.1 months for the IMRT and PBT groups, respectively. Although PBT was superior at reducing low-range (volumes receiving 10{\%} to 40{\%} of the dose, respectively) bladder and rectal doses (all P = .05). Five-year grade >= 2 GU and grade >= 1 GI TFS was 61.1{\%} and 73.7{\%} for IMRT, respectively, and 70.7{\%} and 75.3{\%} for PBT, respectively; and 5-year grade >= 3 GU and GI TFS was >95{\%} for both groups (all P >= .05). Conclusions Postprostatectomy PBT minimized low-range bladder and rectal doses relative to IMRT; however, treatment modality was not associated with clinician-reported GU/GI toxicities. Future prospective investigation and ongoing follow-up will determine whether dosimetric differences between IMRT and PBT confer clinically meaningful differences in long-term outcomes.",
keywords = "adjuvant radiation, gastrointestinal toxicity, genitourinary toxicity, intensity-modulated radiation therapy, postoperative radiation, prostate cancer, proton therapy, salvage radiation, CONFORMAL RADIATION-THERAPY, LATE URINARY TOXICITY, RADICAL PROSTATECTOMY, ADJUVANT RADIOTHERAPY, PHOTON RADIATION, HYPOFRACTIONATED RADIOTHERAPY, SALVAGE RADIOTHERAPY, DISEASE-CONTROL, FRACTURE RISK, VOLUME",
author = "Santos, {Patricia Mae G.} and Barsky, {Andrew R.} and Wei-Ting Hwang and Curtiland Deville and Xingmei Wang and Stefan Both and Bekelman, {Justin E.} and Christodouleas, {John P.} and Neha Vapiwala",
year = "2019",
month = "9",
day = "10",
doi = "10.1002/cncr.32457",
language = "English",
journal = "Cancer",
issn = "0008-543X",
publisher = "Wiley",

}

RIS

TY - JOUR

T1 - Comparative toxicity outcomes of proton-beam therapy versus intensity-modulated radiotherapy for prostate cancer in the postoperative setting

AU - Santos, Patricia Mae G.

AU - Barsky, Andrew R.

AU - Hwang, Wei-Ting

AU - Deville, Curtiland

AU - Wang, Xingmei

AU - Both, Stefan

AU - Bekelman, Justin E.

AU - Christodouleas, John P.

AU - Vapiwala, Neha

PY - 2019/9/10

Y1 - 2019/9/10

N2 - Background Despite increasing utilization of proton-beam therapy (PBT) in the postprostatectomy setting, no data exist regarding toxicity outcomes relative to intensity-modulated radiotherapy (IMRT). The authors compared acute and late genitourinary (GU) and gastrointestinal (GI) toxicity outcomes in patients with prostate cancer (PC) who received treatment with postprostatectomy IMRT versus PBT. Methods With institutional review board approval, patients with PC who received adjuvant or salvage IMRT or PBT (70.2 gray with an endorectal balloon) after prostatectomy from 2009 through 2017 were reviewed. Factors including combined IMRT and PBT and/or concurrent malignancies prompted exclusion. A case-matched cohort analysis was performed using nearest-neighbor 3-to-1 matching by age and GU/GI disorder history. Logistic and Cox regressions were used to identify univariate and multivariate associations between toxicities and cohort/dosimetric characteristics. Toxicity-free survival (TFS) was assessed using the Kaplan-Meier method. Results Three hundred seven men (mean +/- SD age, 59.7 +/- 6.3 years; IMRT, n = 237; PBT, n = 70) were identified, generating 70 matched pairs. The median follow-up was 48.6 and 46.1 months for the IMRT and PBT groups, respectively. Although PBT was superior at reducing low-range (volumes receiving 10% to 40% of the dose, respectively) bladder and rectal doses (all P = .05). Five-year grade >= 2 GU and grade >= 1 GI TFS was 61.1% and 73.7% for IMRT, respectively, and 70.7% and 75.3% for PBT, respectively; and 5-year grade >= 3 GU and GI TFS was >95% for both groups (all P >= .05). Conclusions Postprostatectomy PBT minimized low-range bladder and rectal doses relative to IMRT; however, treatment modality was not associated with clinician-reported GU/GI toxicities. Future prospective investigation and ongoing follow-up will determine whether dosimetric differences between IMRT and PBT confer clinically meaningful differences in long-term outcomes.

AB - Background Despite increasing utilization of proton-beam therapy (PBT) in the postprostatectomy setting, no data exist regarding toxicity outcomes relative to intensity-modulated radiotherapy (IMRT). The authors compared acute and late genitourinary (GU) and gastrointestinal (GI) toxicity outcomes in patients with prostate cancer (PC) who received treatment with postprostatectomy IMRT versus PBT. Methods With institutional review board approval, patients with PC who received adjuvant or salvage IMRT or PBT (70.2 gray with an endorectal balloon) after prostatectomy from 2009 through 2017 were reviewed. Factors including combined IMRT and PBT and/or concurrent malignancies prompted exclusion. A case-matched cohort analysis was performed using nearest-neighbor 3-to-1 matching by age and GU/GI disorder history. Logistic and Cox regressions were used to identify univariate and multivariate associations between toxicities and cohort/dosimetric characteristics. Toxicity-free survival (TFS) was assessed using the Kaplan-Meier method. Results Three hundred seven men (mean +/- SD age, 59.7 +/- 6.3 years; IMRT, n = 237; PBT, n = 70) were identified, generating 70 matched pairs. The median follow-up was 48.6 and 46.1 months for the IMRT and PBT groups, respectively. Although PBT was superior at reducing low-range (volumes receiving 10% to 40% of the dose, respectively) bladder and rectal doses (all P = .05). Five-year grade >= 2 GU and grade >= 1 GI TFS was 61.1% and 73.7% for IMRT, respectively, and 70.7% and 75.3% for PBT, respectively; and 5-year grade >= 3 GU and GI TFS was >95% for both groups (all P >= .05). Conclusions Postprostatectomy PBT minimized low-range bladder and rectal doses relative to IMRT; however, treatment modality was not associated with clinician-reported GU/GI toxicities. Future prospective investigation and ongoing follow-up will determine whether dosimetric differences between IMRT and PBT confer clinically meaningful differences in long-term outcomes.

KW - adjuvant radiation

KW - gastrointestinal toxicity

KW - genitourinary toxicity

KW - intensity-modulated radiation therapy

KW - postoperative radiation

KW - prostate cancer

KW - proton therapy

KW - salvage radiation

KW - CONFORMAL RADIATION-THERAPY

KW - LATE URINARY TOXICITY

KW - RADICAL PROSTATECTOMY

KW - ADJUVANT RADIOTHERAPY

KW - PHOTON RADIATION

KW - HYPOFRACTIONATED RADIOTHERAPY

KW - SALVAGE RADIOTHERAPY

KW - DISEASE-CONTROL

KW - FRACTURE RISK

KW - VOLUME

U2 - 10.1002/cncr.32457

DO - 10.1002/cncr.32457

M3 - Article

JO - Cancer

JF - Cancer

SN - 0008-543X

ER -

ID: 98323583