Table 6.
Results (toxicity) comparison with nonrandomized studies using high-dose radiotherapy.
| Study | Number of pts | Adjuvant therapy | RT technique | Toxicity scores | Acute toxicity | Late toxicity |
Notes | ||
|---|---|---|---|---|---|---|---|---|---|
| GI | GU | GI | GU | ||||||
| Nath et al., 2010 [24] | 50 | RT (median dose: 68 Gy) | IMRT-IGRT | CTC 3.0 | G2: 8% G3: 0% |
G2: 14% G3: 0% |
G2: 2% ∗ |
G2: 16% G3: 2% ∗ |
IMRT-IGRT may reduce RT-induced toxicity |
|
| |||||||||
| Cozzarini et al., 2012 [25] | 556 | RT (median dose: 70.2 Gy) ± ENI | 2D or 3D | CTC 3.0 | NR | G2: 19% G3: 8% |
NR | G2: 23.9% G3: 12% † |
Younger and hypertensive pts: higher rate of severe GU late sequelae |
|
| |||||||||
| van Praet et al., 2013 [26] | 48 (pN1) | RT (75 Gy to prostate bed + ENI: 54 Gy) + ADT | IMAT | In-house developed scale | G2: 42% G3: 0% |
G2: 35% G3: 4% |
G2: 25% G3: 0% ‡ |
G2: 36% G3: 7% G4: 2% ‡ |
Acute and late GI toxicity higher following ENI |
|
| |||||||||
| Present series | 123 | RT (64.8–70.2 Gy to prostate bed ± ENI) ± AHT | 3D CRT | Acute: RTOG Late: RTOG-EORTC |
G2: 10.6% G3: 2.4% G4: 0% |
G2: 9.8% G3: 3.3% G4: 0% |
G ≥ 2: 3.7% G ≥ 3: 0% G ≥ 4: 0% § |
G ≥ 2: 12.7% G ≥ 3: 5.8% G ≥ 4: 0% § |
No significant effect on toxicity by age, dose, ENI, and AHT |
3D CRT: 3-dimensional conformal radiation therapy; ADT: androgen deprivation therapy; AHT: adjuvant hormonal therapy; ENI: elective nodal irradiation; GI: gastrointestinal; GU: genitourinary; IGRT: image guided radiation therapy; IMAT: intensity-modulated arc therapy; IMRT: intensity-modulated radiation therapy; pts: patients; ∗: crude, median follow-up: 24 months; †: 8-year risk; ‡: crude (only patients with ≥12-month follow-up); and §: 5-year actuarial cumulative incidence.