Acute and late toxicity in radical radiotherapy of prostate cancer

Abstract

Although radical radiotherapy has proved to be a successful method in prostate cancer treatment, the conventional (box) technique can result in significant adverse events. The objective of our study was to estimate the frequency, type and severity of acute and late toxicity in radical radiotherapy of prostate cancer. In a clinical retrospective study, we included 283 patients with histologically confirmed prostate cancer. All our patients received radical, conventional radiotherapy using the four-field technique. The study was performed at the Radiotherapy Department of the institute for Oncology and Radiology of Serbia between January 1991 and December 2005. During regular follow-up, we analysed the frequency, type and severity of acute and late toxicity. Two thirds (71%) of our patients had acute toxicity of at least one organ within the radiation field. Most frequent complication was radiation dermatitis (10.5%), and enteritis (9%), cystitis (6%) and proctitis (2.5%). Acute adverse events were mostly low grade (I and II, 28-61%). Late complications were registered in 20.5% of patients. Skin fibrosis was most frequent (12%). Chronic proctitis was detected in 4% and urethral stricture in 4.5% of our patients. All late complications were low grade. Treatment tolerance of radical radiotherapy is relatively good. Although most patients develop acute toxicity, it is commonly low grade and requires the interruption of radiotherapy treatment in 20% of patients only. Late toxicity is rarer than acute and, in most cases, it does not affect the quality of life.