High-dose radiation techniques produced differing toxicity profiles

Patients with prostate cancer assigned to external beam radiation with HDR brachytherapy boost experienced higher rates of acute adverse effects.

Issue: March 25, 2011

A comparison of three types of modern high-dose radiation techniques for patients with prostate cancer showed that each produces a unique toxicity profile.

The goal, according to researchers, was to aid physicians and patients in making informed treatment decisions.

“This study provides insight for referring physicians, treating radiation oncologists and patients into the expected toxicities for three modern high-dose radiation treatment techniques,” they wrote. “Presumably, this is due to higher rectal doses with [CT-based offline image-guided radiation therapy]. Each of the three radiation techniques offers a different toxicity profile. These data can help patients and physicians to make informed decisions regarding radiotherapy for prostate adenocarcinoma.”

Mohammed and colleagues studied 1,903 patients with localized prostate cancer who were treated with radiation at William Beaumont Hospital in Royal Oak, Mich., from 1992 to 2006.

Patients and their physicians could select treatment with CT-based offline image-guided radiation therapy, high-dose-rate (HDR) or low-dose-rate brachytherapy monotherapy or external-beam pelvic radiotherapy with HDR brachytherapy boost (EBRT+HDR).

Treatment modality was selected based on a combination of disease characteristics, symptoms, comorbidities, technical qualification and patient/physician preference. Brachytherapy monotherapy or intensity-modulated radiation therapy was, in general, reserved for low-risk patients, whereas patients with more aggressive, intermediate- or high-risk disease were more likely to be assigned EBRT+HDR.

For more information:

Mohammed N. Int J Radiat Oncol Biol Phys. 2010;doi:10.1016/j.ijrobp.2010.10.009.

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