Ethnic Difference in Risk of Toxicity in Prostate Cancer Patients Treated with Dynamic Arc Radiation Therapy

Aims and background The objective of this study was to assess the influence of ethnicity on toxicity in patients treated with dynamic arc radiation therapy (ART) for prostate cancer (PC). Methods From June 2006 to May 2012, 162 cT1-T3 cN0 cM0 PC patients were treated with ART (primary diagnosis, n =...

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Bibliographic Details
Published in:Tumori 2015-07, Vol.101 (4), p.461-468
Main Authors: Guerra, Jose L. Lopez, Matute, Raul, Puebla, Fernando, Sánchez-Reyes, Alberto, Pontes, Beatriz, Rubio, Cristina, Nepomuceno, Isabel, Acevedo, Catalina, Isa, Nicolas, Lengua, Rafael, Praena-Fernandez, Juan Manuel, del Campo, Eleonor Rivin, Ortiz, Maria Jose, Azinovic, Ignacio
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biomarkers, Tumor - blood
Brachytherapy - adverse effects
European Continental Ancestry Group - statistics & numerical data
Follow-Up Studies
Gastrointestinal Tract - radiation effects
Hispanic Americans - statistics & numerical data
Humans
Lymph Nodes - radiation effects
Lymphatic Metastasis - radiotherapy
Male
Middle Aged
Neoplasm Grading
Odds Ratio
Prostate-Specific Antigen - blood
Prostatectomy
Prostatic Neoplasms - blood
Prostatic Neoplasms - ethnology
Prostatic Neoplasms - pathology
Prostatic Neoplasms - radiotherapy
Prostatic Neoplasms - surgery
Radiation Injuries - ethnology
Radiation Injuries - etiology
Radiotherapy, Adjuvant - adverse effects
Radiotherapy, Adjuvant - methods
Risk Factors
Urogenital System - radiation effects
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Summary:Aims and background The objective of this study was to assess the influence of ethnicity on toxicity in patients treated with dynamic arc radiation therapy (ART) for prostate cancer (PC). Methods From June 2006 to May 2012, 162 cT1-T3 cN0 cM0 PC patients were treated with ART (primary diagnosis, n = 125; post-prostatectomy/brachytherapy biochemical recurrence, n = 26; adjuvant post-prostatectomy, n = 11) at 2 institutions. Forty-five patients were Latin Americans and 117 were Europeans. The dose prescribed to the prostate ranged between 68 Gy and 81 Gy. Results The median age was 69 years (range 43-87 years). The median follow-up was 18 months (range 2-74 months). Overall, only 3 patients died, none due to a cancer-related cause. Biochemical recurrence was seen in 7 patients. The rates of acute grade 2 gastrointestinal (GI) and genitourinary (GU) toxicities were 19.7% and 17%, respectively. Only 1 patient experienced acute grade 3 GI toxicity, whereas 11 patients (6.7%) experienced acute grade 3 GU toxicity. Multivariate analysis showed that undergoing whole pelvic lymph node irradiation was associated with a higher grade of acute GI toxicity (OR: 3.46; p = 0.003). In addition, older age was marginally associated with a higher grade of acute GI toxicity (OR: 2.10; p = 0.074). Finally, ethnicity was associated with acute GU toxicity: Europeans had lower-grade toxicity (OR: 0.27; p = 0.001). Conclusions Our findings suggest an ethnic difference in GU toxicity for PC patients treated with ART. In addition, we found that ART is associated with a very low risk of severe toxicity and a low recurrence rate.
ISSN:0300-8916
2038-2529
DOI:10.5301/tj.5000346