Acute and Late Toxicity of Prostate Radiation Therapy Utilizing Fiducial Versus Cone Beam Computed Tomography Daily Alignment

Abstract

Purpose/Objective(s)To compare the rates of acute and late gastrointestinal (GI) and genitourinary (GU) toxicity associated with daily alignment to implanted fiducials via kV radiographs versus alignment to the prostate via cone-beam computed tomography (CBCT).Materials/MethodsTwo hundred twelve patients with clinically localized prostate cancer treated with hypofractionated prostate radiation therapy (RT) between 2005 and 2011 were included in this analysis. All patients received 70 Gy to the prostate in 28 fractions and 103 patients received simultaneous 50.4 Gy to the pelvic lymph nodes. Daily image-guided alignment was performed either to implanted fiducial markers with kV radiographs or to the prostate or prostate-rectum interface via CBCT. Acute and late GI and GU toxicity were retrospectively scored by the CTCAE 4.0 scale and statistical analysis was performed using IBM SPSS version 22 software.ResultsScientific Abstract 2589; TableProstate-only (n = 109)Fiducials (n = 23)CBCT (n = 86)PAcute GI217.214Acute GU1141.990Late GI32.020Late GU26.650Lymph Nodes treated (n = 103)Fiducials (n = 19)CBCT (n = 84)PAcute GI731.996Acute GU1341.122Late GI113.383Late GU17.842 Open table in a new tab ConclusionsThe acute GU and GI toxicities are similar in patients receiving fiducial-based or CBCT alignment. For patients receiving prostate-only RT, the rate of late GI toxicity was increased for patients with implanted fiducials. Late GU toxicity was not increased for patients receiving fiducial-based alignment despite the inability to evaluate daily bladder filling in this group. Purpose/Objective(s)To compare the rates of acute and late gastrointestinal (GI) and genitourinary (GU) toxicity associated with daily alignment to implanted fiducials via kV radiographs versus alignment to the prostate via cone-beam computed tomography (CBCT). To compare the rates of acute and late gastrointestinal (GI) and genitourinary (GU) toxicity associated with daily alignment to implanted fiducials via kV radiographs versus alignment to the prostate via cone-beam computed tomography (CBCT). Materials/MethodsTwo hundred twelve patients with clinically localized prostate cancer treated with hypofractionated prostate radiation therapy (RT) between 2005 and 2011 were included in this analysis. All patients received 70 Gy to the prostate in 28 fractions and 103 patients received simultaneous 50.4 Gy to the pelvic lymph nodes. Daily image-guided alignment was performed either to implanted fiducial markers with kV radiographs or to the prostate or prostate-rectum interface via CBCT. Acute and late GI and GU toxicity were retrospectively scored by the CTCAE 4.0 scale and statistical analysis was performed using IBM SPSS version 22 software. Two hundred twelve patients with clinically localized prostate cancer treated with hypofractionated prostate radiation therapy (RT) between 2005 and 2011 were included in this analysis. All patients received 70 Gy to the prostate in 28 fractions and 103 patients received simultaneous 50.4 Gy to the pelvic lymph nodes. Daily image-guided alignment was performed either to implanted fiducial markers with kV radiographs or to the prostate or prostate-rectum interface via CBCT. Acute and late GI and GU toxicity were retrospectively scored by the CTCAE 4.0 scale and statistical analysis was performed using IBM SPSS version 22 software. ResultsScientific Abstract 2589; TableProstate-only (n = 109)Fiducials (n = 23)CBCT (n = 86)PAcute GI217.214Acute GU1141.990Late GI32.020Late GU26.650Lymph Nodes treated (n = 103)Fiducials (n = 19)CBCT (n = 84)PAcute GI731.996Acute GU1341.122Late GI113.383Late GU17.842 Open table in a new tab ConclusionsThe acute GU and GI toxicities are similar in patients receiving fiducial-based or CBCT alignment. For patients receiving prostate-only RT, the rate of late GI toxicity was increased for patients with implanted fiducials. Late GU toxicity was not increased for patients receiving fiducial-based alignment despite the inability to evaluate daily bladder filling in this group. The acute GU and GI toxicities are similar in patients receiving fiducial-based or CBCT alignment. For patients receiving prostate-only RT, the rate of late GI toxicity was increased for patients with implanted fiducials. Late GU toxicity was not increased for patients receiving fiducial-based alignment despite the inability to evaluate daily bladder filling in this group.