dc.contributor.author | Brand, DH | |
dc.contributor.author | Brüningk, SC | |
dc.contributor.author | Wilkins, A | |
dc.contributor.author | Naismith, O | |
dc.contributor.author | Gao, A | |
dc.contributor.author | Syndikus, I | |
dc.contributor.author | Dearnaley, DP | |
dc.contributor.author | Hall, E | |
dc.contributor.author | van As, N | |
dc.contributor.author | Tree, AC | |
dc.contributor.author | Gulliford, S | |
dc.coverage.spatial | United States | |
dc.date.accessioned | 2023-10-02T11:34:57Z | |
dc.date.available | 2023-10-02T11:34:57Z | |
dc.date.issued | 2023-12-01 | |
dc.identifier | S0360-3016(23)07628-9 | |
dc.identifier.citation | International Journal of Radiation: Oncology - Biology - Physics, 2023, pp. S0360-3016(23)07628-9 - | |
dc.identifier.issn | 0360-3016 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/6003 | |
dc.identifier.eissn | 1879-355X | |
dc.identifier.eissn | 1879-355X | |
dc.identifier.doi | 10.1016/j.ijrobp.2023.07.002 | |
dc.description.abstract | PURPOSE: Rectal dose delivered during prostate radiation therapy is associated with gastrointestinal toxicity. Treatment plans are commonly optimized using rectal dose-volume constraints, often whole-rectum relative-volumes (%). We investigated whether improved rectal contouring, use of absolute-volumes (cc), or rectal truncation might improve toxicity prediction. METHODS AND MATERIALS: Patients from the CHHiP trial (receiving 74 Gy/37 fractions [Fr] vs 60 Gy/20 Fr vs 57 Gy/19 Fr) were included if radiation therapy plans were available (2350/3216 patients), plus toxicity data for relevant analyses (2170/3216 patients). Whole solid rectum relative-volumes (%) dose-volume-histogram (DVH), as submitted by treating center (original contour), was assumed standard-of-care. Three investigational rectal DVHs were generated: (1) reviewed contour per CHHiP protocol; (2) original contour absolute volumes (cc); and (3) truncated original contour (2 versions; ±0 and ±2 cm from planning target volume [PTV]). Dose levels of interest (V30, 40, 50, 60, 70, 74 Gy) in 74 Gy arm were converted by equivalent-dose-in-2 Gy-Fr (EQD2α/β= 3 Gy) for 60 Gy/57 Gy arms. Bootstrapped logistic models predicting late toxicities (frequency G1+/G2+, bleeding G1+/G2+, proctitis G1+/G2+, sphincter control G1+, stricture/ulcer G1+) were compared by area-undercurve (AUC) between standard of care and the 3 investigational rectal definitions. RESULTS: The alternative dose/volume parameters were compared with the original relative-volume (%) DVH of the whole rectal contour, itself fitted as a weak predictor of toxicity (AUC range, 0.57-0.65 across the 8 toxicity measures). There were no significant differences in toxicity prediction for: (1) original versus reviewed rectal contours (AUCs, 0.57-0.66; P = .21-.98); (2) relative- versus absolute-volumes (AUCs, 0.56-0.63; P = .07-.91); and (3) whole-rectum versus truncation at PTV ± 2 cm (AUCs, 0.57-0.65; P = .05-.99) or PTV ± 0 cm (AUCs, 0.57-0.66; P = .27-.98). CONCLUSIONS: We used whole-rectum relative-volume DVH, submitted by the treating center, as the standard-of-care dosimetric predictor for rectal toxicity. There were no statistically significant differences in prediction performance when using central rectal contour review, with the use of absolute-volume dosimetry, or with rectal truncation relative to PTV. Whole-rectum relative-volumes were not improved upon for toxicity prediction and should remain standard-of-care. | |
dc.format | Print-Electronic | |
dc.format.extent | S0360-3016(23)07628-9 - | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | ELSEVIER SCIENCE INC | |
dc.relation.ispartof | International Journal of Radiation: Oncology - Biology - Physics | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject | CHHiP Trial Management Group | |
dc.title | Gastrointestinal Toxicity Prediction Not Influenced by Rectal Contour or Dose-Volume Histogram Definition. | |
dc.type | Journal Article | |
dcterms.dateAccepted | 2023-07-03 | |
dc.date.updated | 2023-10-02T11:34:08Z | |
rioxxterms.version | VoR | |
rioxxterms.versionofrecord | 10.1016/j.ijrobp.2023.07.002 | |
rioxxterms.licenseref.startdate | 2023-07-16 | |
rioxxterms.type | Journal Article/Review | |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/37433374 | |
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/Cancer Biology | |
pubs.organisational-group | ICR/Primary Group/ICR Divisions/Cancer Biology/Targeted Therapy | |
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/Closed research teams | |
pubs.organisational-group | ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging | |
pubs.organisational-group | ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Stereotactic and Precision Body Radiotherapy | |
pubs.organisational-group | ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Targeted Therapy | |
pubs.organisational-group | ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley) | |
pubs.organisational-group | ICR/Students | |
pubs.organisational-group | ICR/Students/PhD and MPhil | |
pubs.organisational-group | ICR/Students/PhD and MPhil/17/18 Starting Cohort | |
pubs.organisational-group | ICR/ImmNet | |
pubs.organisational-group | ICR/Students/PhD and MPhil/13/14 Starting Cohort | |
pubs.publication-status | Published online | |
icr.researchteam | Stereotactic Radiother | |
icr.researchteam | Targeted Therapy | |
icr.researchteam | Clinic Acad RT Dearnaley | |
icr.researchteam | Clin Trials & Stats Unit | |
dc.contributor.icrauthor | Brand, Douglas | |
dc.contributor.icrauthor | Corbett, Anna | |
dc.contributor.icrauthor | Gao, Annie | |
dc.contributor.icrauthor | Dearnaley, David | |
dc.contributor.icrauthor | Hall, Emma | |
icr.provenance | Deposited by Mr Arek Surman on 2023-10-02. Deposit type is initial. No. of files: 1. Files: 1-s2.0-S0360301623076289-main.pdf | |