Forward- and Inverse-Planned Intensity-Modulated Radiotherapy in the CHHiP Trial: A Comparison of Dosimetry and Normal Tissue Toxicity

Overview

Journal Clin Oncol (R Coll Radiol)

Specialty Oncology

Date 2019 Jun 11

PMID 31178346

Citations 2

Authors

O F Naismith

C Griffin

I Syndikus

C South

H Mayles

P Mayles

V Khoo

C Scrase

J Graham

S Hassan

E Hall

D P Dearnaley

Affiliations

Soon will be listed here.

Abstract

Aims: The CHHiP (Conventional or Hypofractionated High-dose Intensity Modulated Radiotherapy In Prostate Cancer; CRUK/06/016) trial investigated hypofractionated radiotherapy for localised prostate cancer. Forward- (FP) or inverse-planned (IP) intensity-modulated techniques were permitted. Dose-volume histogram and toxicity data were compared to explore the effects of planning method.

Materials And Methods: In total, 337 participants with intermediate-risk disease and prospectively collected toxicity data were included. Patients were matched on prostate and rectum/bladder volumes and on radiotherapy dose for toxicity comparisons. The primary outcome was grade 2 or higher Radiation Therapy Oncology Group (RTOG) bowel or bladder toxicity at 2 years.

Results: IP patients had smaller volumes of rectum irradiated to 50-70 Gy (P < 0.001); FP patients had smaller volumes of bladder irradiated to 74 Gy (P = 0.001). Acute grade 2 + bowel toxicity was worse with FP (27/53 [52%]; 11/53 [21%] IP; P = 0.0002); with no significant differences in acute urinary toxicity. At 2 years, RTOG grade 2 + bowel toxicity rates were FP 0/53 and IP 2/53 and RTOG grade 2 + bladder rates were FP 0/54 and IP 1/57.

Conclusions: Significant differences were found between dose-volume histograms from FP and IP methods. IP may result in small reductions in acute bowel toxicity but both techniques were associated with low rates of late radiotherapy side-effects.

Citing Articles

A Comparison of Field-in-Field and Intensity Modulated Radiation Therapy in Delivering Hypofractionated Radiation Therapy for Prostate Cancer.

Ghafour H, Ali J, Taher Ali R, Sirelkhatim E Adv Radiat Oncol. 2024; 9(2):101356.

PMID: 38405309 PMC: 10885577. DOI: 10.1016/j.adro.2023.101356.

A comparison of a moderately hypofractionated IMRT planning technique used in a randomised UK external beam radiotherapy trial with an in-house technique for localised prostate cancer.

Gleeson I Rep Pract Oncol Radiother. 2020; 25(3):360-366.

PMID: 32256220 PMC: 7118276. DOI: 10.1016/j.rpor.2020.03.010.

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