PMID- 38001594 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231127 IS - 2072-6694 (Print) IS - 2072-6694 (Electronic) IS - 2072-6694 (Linking) VI - 15 IP - 22 DP - 2023 Nov 9 TI - Rectum and Bladder Toxicity in Postoperative Prostate Bed Irradiation: Dose-Volume Parameters Analysis. LID - 10.3390/cancers15225334 [doi] LID - 5334 AB - Although prostate cancer treatment is increasingly effective, its toxicities pose a major concern. The aim of our study was to assess the rate of adverse events (AEs) and the prognostic value of dose-volume histogram (DVH) parameters for the occurrence of treatment toxicity in patients treated with post-prostatectomy prostate bed radiotherapy (RT). The AEs were scored according to the CTCAE v.5.0. The rectum and bladder were contoured according to the RTOG Guidelines. The DVH parameters were assessed using data exported from the ECLIPSE treatment-planning system. Genitourinary (GU) and gastrointestinal (GI) toxicity were analysed using consecutive dose thresholds for the percentage of an organ at risk (OAR) receiving a given dose and the QUANTEC dose constraints. A total of 213 patients were included in the final analysis. Acute grade 2 or higher (>/=G2) GU AEs occurred in 18.7% and late in 21.3% of patients. Acute >/=G2 GI toxicity occurred in 11.7% and late >/=G2 in 11.2% of the patients. Five patients experienced grade 4 AEs. The most common adverse effects were diarrhoea, proctitis, cystitis, and dysuria. The most significant predictors of acute >/=G2 GI toxicity were rectum V47 and V46 (p < 0.001 and p < 0.001) and rectum wall V46 (p = 0.001), whereas the most significant predictors of late >/=G2 GI AEs were rectum wall V47 and V48 (p = 0.019 and p = 0.021). None of the bladder or bladder wall parameters was significantly associated with the risk of acute toxicity. The minimum doses to bladder wall (p = 0.004) and bladder (p = 0.005) were the most significant predictors of late >/=G2 GU toxicity. Postoperative radiotherapy is associated with a clinically relevant risk of AEs, which is associated with DVH parameters, and remains even in patients who fulfil commonly accepted dose constraints. Considering the lack of survival benefit of postoperative adjuvant RT, our results support delaying treatment through an early salvage approach to avoid or defer toxicity. FAU - Hasterok, Maja AU - Hasterok M AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Szoltysik, Monika AU - Szoltysik M AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Nowicka, Zuzanna AU - Nowicka Z AD - Department of Biostatistics and Translational Medicine, Medical University of Lodz, Mazowiecka 15, 92-215 Lodz, Poland. FAU - Goc, Bartlomiej AU - Goc B AD - Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Graupner, Donata AU - Graupner D AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Majewski, Wojciech AU - Majewski W AD - Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Raslawski, Konrad AU - Raslawski K AD - Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Rajwa, Pawel AU - Rajwa P AD - Department of Urology, Medical University of Vienna, Wahringer Gurtel 18-20, 1090 Vienna, Austria. AD - Department of Urology, Medical University of Silesia, 3-go Maja 13-15, 41-800 Zabrze, Poland. FAU - Jablonska, Iwona AU - Jablonska I AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Magrowski, Lukasz AU - Magrowski L AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Przydacz, Mikolaj AU - Przydacz M AUID- ORCID: 0000-0002-7381-7420 AD - Department of Urology, Jagiellonian University Medical College, Macieja Jakubowskiego 2, 30-688 Krakow, Poland. FAU - Krajewski, Wojciech AU - Krajewski W AD - Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland. FAU - Masri, Oliwia AU - Masri O AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Miszczyk, Marcin AU - Miszczyk M AUID- ORCID: 0000-0002-4375-0827 AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. LA - eng PT - Journal Article DEP - 20231109 PL - Switzerland TA - Cancers (Basel) JT - Cancers JID - 101526829 PMC - PMC10670737 OTO - NOTNLM OT - QUANTEC OT - adjuvant radiotherapy OT - adverse events OT - dose constraints OT - dose-volume histogram OT - postoperative irradiation OT - prostate cancer OT - salvage radiotherapy COIS- The authors declare no conflict of interest. EDAT- 2023/11/25 12:45 MHDA- 2023/11/25 12:46 PMCR- 2023/11/09 CRDT- 2023/11/25 01:05 PHST- 2023/10/24 00:00 [received] PHST- 2023/11/01 00:00 [accepted] PHST- 2023/11/25 12:46 [medline] PHST- 2023/11/25 12:45 [pubmed] PHST- 2023/11/25 01:05 [entrez] PHST- 2023/11/09 00:00 [pmc-release] AID - cancers15225334 [pii] AID - cancers-15-05334 [pii] AID - 10.3390/cancers15225334 [doi] PST - epublish SO - Cancers (Basel). 2023 Nov 9;15(22):5334. doi: 10.3390/cancers15225334.