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dc.contributor.authorMurray, J
dc.contributor.authorGriffin, C
dc.contributor.authorGulliford, S
dc.contributor.authorSyndikus, I
dc.contributor.authorStaffurth, J
dc.contributor.authorPanades, M
dc.contributor.authorScrase, C
dc.contributor.authorParker, C
dc.contributor.authorKhoo, V
dc.contributor.authorDean, J
dc.contributor.authorMayles, H
dc.contributor.authorMayles, P
dc.contributor.authorThomas, S
dc.contributor.authorNaismith, O
dc.contributor.authorBaker, A
dc.contributor.authorMossop, H
dc.contributor.authorCruickshank, C
dc.contributor.authorHall, E
dc.contributor.authorDearnaley, D
dc.contributor.authorCHHiP Investigators,
dc.date.accessioned2019-11-12T14:45:08Z
dc.date.issued2020-01-01
dc.identifier.citationRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2020, 142 pp. 62 - 71
dc.identifier.issn0167-8140
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3409
dc.identifier.eissn1879-0887
dc.identifier.doi10.1016/j.radonc.2019.10.017
dc.description.abstractBACKGROUND 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.formatPrint-Electronic
dc.format.extent62 - 71
dc.languageeng
dc.language.isoeng
dc.publisherELSEVIER IRELAND LTD
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectCHHiP Investigators
dc.subjectRectum
dc.subjectHumans
dc.subjectProstatic Neoplasms
dc.subjectNeoplasm Staging
dc.subjectRadiotherapy Planning, Computer-Assisted
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectMale
dc.subjectRadiotherapy, Intensity-Modulated
dc.subjectFiducial Markers
dc.subjectRadiotherapy, Image-Guided
dc.subjectPatient Reported Outcome Measures
dc.subjectRadiation Dose Hypofractionation
dc.titleA randomised assessment of image guided radiotherapy within a phase 3 trial of conventional or hypofractionated high dose intensity modulated radiotherapy for prostate cancer.
dc.typeJournal Article
dcterms.dateAccepted2019-10-25
rioxxterms.versionofrecord10.1016/j.radonc.2019.10.017
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2020-01
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
pubs.notesNot 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-statusPublished
pubs.volume142
pubs.embargo.termsNot known
icr.researchteamClinical Trials & Statistics Unit
icr.researchteamICR-CTSU Urology and Head and Neck Trials Team
icr.researchteamClinical Academic Radiotherapy (Dearnaley)
icr.researchteamRadiotherapy Physics Modelling
dc.contributor.icrauthorMurray, Julia
dc.contributor.icrauthorGriffin, Clare
dc.contributor.icrauthorCruickshank, Clare
dc.contributor.icrauthorHall, Emma
dc.contributor.icrauthorDearnaley, David


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