dc.contributor.author | Murray, J | |
dc.contributor.author | Griffin, C | |
dc.contributor.author | Gulliford, S | |
dc.contributor.author | Syndikus, I | |
dc.contributor.author | Staffurth, J | |
dc.contributor.author | Panades, M | |
dc.contributor.author | Scrase, C | |
dc.contributor.author | Parker, C | |
dc.contributor.author | Khoo, V | |
dc.contributor.author | Dean, J | |
dc.contributor.author | Mayles, H | |
dc.contributor.author | Mayles, P | |
dc.contributor.author | Thomas, S | |
dc.contributor.author | Naismith, O | |
dc.contributor.author | Baker, A | |
dc.contributor.author | Mossop, H | |
dc.contributor.author | Cruickshank, C | |
dc.contributor.author | Hall, E | |
dc.contributor.author | Dearnaley, D | |
dc.contributor.author | CHHiP Investigators, | |
dc.date.accessioned | 2019-11-12T14:45:08Z | |
dc.date.issued | 2020-01-01 | |
dc.identifier.citation | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2020, 142 pp. 62 - 71 | |
dc.identifier.issn | 0167-8140 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/3409 | |
dc.identifier.eissn | 1879-0887 | |
dc.identifier.doi | 10.1016/j.radonc.2019.10.017 | |
dc.description.abstract | BACKGROUND AND PURPOSE: Image-guided radiotherapy (IGRT) improves treatment set-up accuracy and provides the opportunity to reduce target volume margins. We introduced IGRT methods using standard (IGRT-S) or reduced (IGRT-R) margins in a randomised phase 2 substudy within CHHiP trial. We present a pre-planned analysis of the impact of IGRT on dosimetry and acute/late pelvic side effects using gastrointestinal and genitourinary clinician and patient-reported outcomes (PRO) and evaluate efficacy. MATERIALS AND METHODS: CHHiP is a randomised phase 3, non-inferiority trial for men with localised prostate cancer. 3216 patients were randomly assigned to conventional (74 Gy in 2 Gy/fraction (f) daily) or moderate hypofractionation (60 or 57 Gy in 3 Gy/f daily) between October 2002 and June 2011. The IGRT substudy included a second randomisation assigning to no-IGRT, IGRT-S (standard CTV-PTV margins), or IGRT-R (reduced CTV-PTV margins). Primary substudy endpoint was late RTOG bowel and urinary toxicity at 2 years post-radiotherapy. RESULTS: Between June 2010 to July 2011, 293 men were recruited from 16 centres. Median follow-up is 56.9(IQR 54.3-60.9) months. Rectal and bladder dose-volume and surface percentages were significantly lower in IGRT-R compared to IGRT-S group; (p < 0.0001). Cumulative proportion with RTOG grade ≥ 2 toxicity reported to 2 years for bowel was 8.3(95% CI 3.2-20.7)%, 8.3(4.7-14.6)% and 5.8(2.6-12.4)% and for urinary 8.4(3.2-20.8)%, 4.6(2.1-9.9)% and 3.9(1.5-9.9)% in no IGRT, IGRT-S and IGRT-R groups respectively. In an exploratory analysis, treatment efficacy appeared similar in all three groups. CONCLUSION: Introduction of IGRT was feasible in a national randomised trial and IGRT-R produced dosimetric benefits. Overall side effect profiles were acceptable in all groups but lowest with IGRT and reduced margins. ISRCTN: 97182923. | |
dc.format | Print-Electronic | |
dc.format.extent | 62 - 71 | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | ELSEVIER IRELAND LTD | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0 | |
dc.subject | CHHiP Investigators | |
dc.subject | Rectum | |
dc.subject | Humans | |
dc.subject | Prostatic Neoplasms | |
dc.subject | Neoplasm Staging | |
dc.subject | Radiotherapy Planning, Computer-Assisted | |
dc.subject | Aged | |
dc.subject | Aged, 80 and over | |
dc.subject | Middle Aged | |
dc.subject | Male | |
dc.subject | Radiotherapy, Intensity-Modulated | |
dc.subject | Fiducial Markers | |
dc.subject | Radiotherapy, Image-Guided | |
dc.subject | Patient Reported Outcome Measures | |
dc.subject | Radiation Dose Hypofractionation | |
dc.title | A randomised assessment of image guided radiotherapy within a phase 3 trial of conventional or hypofractionated high dose intensity modulated radiotherapy for prostate cancer. | |
dc.type | Journal Article | |
dcterms.dateAccepted | 2019-10-25 | |
rioxxterms.versionofrecord | 10.1016/j.radonc.2019.10.017 | |
rioxxterms.licenseref.uri | https://creativecommons.org/licenses/by/4.0 | |
rioxxterms.licenseref.startdate | 2020-01 | |
rioxxterms.type | Journal Article/Review | |
dc.relation.isPartOf | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology | |
pubs.notes | Not known | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/ICR-CTSU Urology and Head and Neck Trials Team | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Closed research teams | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley) | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Radiotherapy Physics Modelling | |
pubs.organisational-group | /ICR/Primary Group/Royal Marsden Clinical Units | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/ICR-CTSU Urology and Head and Neck Trials Team | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Closed research teams | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley) | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Radiotherapy Physics Modelling | |
pubs.organisational-group | /ICR/Primary Group/Royal Marsden Clinical Units | |
pubs.publication-status | Published | |
pubs.volume | 142 | |
pubs.embargo.terms | Not known | |
icr.researchteam | Clinical Trials & Statistics Unit | |
icr.researchteam | ICR-CTSU Urology and Head and Neck Trials Team | |
icr.researchteam | Clinical Academic Radiotherapy (Dearnaley) | |
icr.researchteam | Radiotherapy Physics Modelling | |
dc.contributor.icrauthor | Murray, Julia | |
dc.contributor.icrauthor | Griffin, Clare | |
dc.contributor.icrauthor | Cruickshank, Clare | |
dc.contributor.icrauthor | Hall, Emma | |
dc.contributor.icrauthor | Dearnaley, David | |