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Multicenter Study
. 2020 May-Jun;34(3):1297-1305.
doi: 10.21873/invivo.11905.

BIT-ART: Multicentric Comparison of HDR-brachytherapy, Intensity-modulated Radiotherapy and Tomotherapy for Advanced Radiotherapy in Prostate Cancer

Anna Rita Alitto  1 , Luca Tagliaferri  1 , Valentina Lancellotta  2 , Andrea D'Aviero  3 , Antonio Piras  3 , Vincenzo Frascino  1 , Francesco Catucci  1 , Bruno Fionda  1 , Christian Staackmann  4 , Simonetta Saldi  5 , Vincenzo Valentini  1   3 , Gyorgy Kovacs  4   6 , Cynthia Aristei  5 , Giovanna Mantini  1   3
Affiliations
Multicenter Study

BIT-ART: Multicentric Comparison of HDR-brachytherapy, Intensity-modulated Radiotherapy and Tomotherapy for Advanced Radiotherapy in Prostate Cancer

Anna Rita Alitto et al. In Vivo. 2020 May-Jun.

Abstract

Background/aim: The aim of the study was to evaluate acute and late genitourinary (GU) and gastrointestinal (GI) toxicity in patients with high- or intermediate-risk prostate cancer.

Patients and methods: We evaluated data of patients from three Radiation Oncology Departments (Rome, Lübeck and Perugia). Patients treated in Rome underwent exclusive intensity-modulated-radiotherapy (IMRT) or IMRT plus high-dose-rate interventional radiotherapy (HDR-IRT). IMRT plus two fractions HDR-IRT was performed in Lübeck, while in Perugia Helical Tomotherapy was performed. The Common Toxicity Criteria for Adverse Event (Version 4.03) scale was used to describe acute and late toxicity.

Results: At a median follow-up of 28 months, all 51 patients were alive and disease-free. Patients treated by HDR-IRT plus VMAT showed only G1-2 genitourinary- gastrointestinal (GU-GI) acute and late toxicity. Univariate analysis showed a lower risk of acute GU toxicity (p=0.048) in IMRT+HDR-IRT.

Conclusion: Low grade and less acute GU toxicity was observed in patients undergoing HDR-IRT boost.

Keywords: HDR brachytherapy; Personalized medicine; VMAT; focal therapy; helical tomotherapy; prostate cancer; toxicity.

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Conflict of interest statement

The Authors have declared no conflicts of interest regarding this study

Figures

Figure 1
Figure 1. Dose distribution of HDR-IRT (Rome 1a) and biological planning (Luebeck 1b). Axial views show high conformality of HDR-IRT. a) Isodose lines: Cyan 15.0 Gy – Green 17.25 Gy – Red 37.5 Gy. b) Isodose lines: Yellow 7.5 Gy – Green 10.00 Gy – Red 15.0 Gy – Blue 30.0 Gy.
Figure 2
Figure 2. Dose distribution of helical tomotherapy (HT). Axial views show dose distribution relative to HT planning target volumes (PTVs) and organs at risk (Perugia)
Figure 3
Figure 3. Dose distribution of intensity modulated radiotherapy (IMRT). Axial views show dose distribution relative to IMRT planning target volumes (PTVs) and organs at risk (Rome 3a and Luebeck 3b)
See this image and copyright information in PMC

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