The effect of image-guided radiation therapy on rectal and urinary toxicity when radiating the prostatic fossa.

Abstract

137 Background: The 2013 ASTRO/AUA consensus statement reports that most outcome data for patients with biochemical failure is based on the use of older treatment techniques. Studies reporting outcomes for patients treated with modern techniques are needed. Methods: Patients were treated using the EORTC guidelines for determining the prostate fossa volume and radiation dose was above 64 Gray. 3D conformal planning and 3D treatment techniques including IMRT and VMAT were used. Daily image guidance was introduced in 2008 using cone beam CT scan and KV/KV imaging using surgical clips as fiducial markers. Toxicity and side effects were recorded and compared to patients treated prior to introduction of image guidance. Results: The Table shows toxicity results prior to and after introduction of daily image guidance. χ2 analysis indicates significant differences for GI, GU and overall toxicity between pre-IGRT and post-IGRT patient groups. Conclusions: Our results are consistent with other reports showing that salvage radiation therapy to the prostatic fossa or prostatic fossa and pelvic lymph nodes is well tolerated with few significant acute or late complications. We noted a significant decrease in GI toxicity and in GU toxicity with the introduction of image guidance techniques. [Table: see text]