Conformal radiation in prostate cancer: Reduced morbidity with hope of increased local control

Abstract

The article by S. Vijayakumar et al. relates to one of the most exciting areas of clinical research in radiation oncology: the development of conformal radiation therapy of prostate cancer and the benefits that we will see in reduced acute morbidity. In 1992 we published the first article showing a significant reduction in acute morbidity as measured by a reduction in the requirements for medication for bladder and/or bowel symptoms during treatment (RTOG/EORTC grade II acute complications). We believe this improvement was due to reduced bladdar and rectal exposure with conformal therapy calculated at 14% from dose volume histograms. The Vijayakumar article cites our contribution as one of several studies of acute toxicity of conventional therapy.' In addition, at ASTRO 1991, Emami et al. presented their results showing a similar reduced toxicity and their dose volume histograms showed an identical 14% reduction in bladder and rectal dose. In their program of conformal beams eye view (BEV) treatment of prostate cancer, Sandler et al. have led the way in late complications by reporting that they have observed no grade III or IV toxicity.