Organs at risks | Dose constrain | Mean | Median (range) |
---|---|---|---|
D 0.04cm3 (Gy) | 38 | 37.6 | 37.8 (32.3–41.5) |
D 20cm3 (Gy) | 26 | 18.8 | 19.2 (8.0–27.6) |
D 0.04cm3 (Gy) | 44 | 40.4 | 40.4 (30.7–48.6) |
D 15cm3 (Gy) | 18.3 | 29.1 | 18.9 (6.9–29.1) |
V 26Gy (%) | 65 | 9.1 | 7.3 (0.9–41.9) |
Rectum | D0.04ccm < 38 Gy, D20ccm < 25 Gy |
---|---|
Bladder | V26% < 65% |
Bladder wall | D0.04ccm < 44 Gy |
Sigma | D0.04ccm < 44 Gy, V30Gy < 1ccm |
Small intestine | D0.04ccm < 35 Gy, V30Gy < 1ccm, D5ccm < 19.5 Gy |
Hip joint | V40% < 5%, D10ccm < 30 Gy |
Testicle | D20% < 2Gy |
Penis root | V29.5Gy < 50%, D0.04ccm < 50 Gy |
Characteristic | Number (%) |
---|---|
Median | 73 |
Range | 54–85 |
T1 | 45 (22%) |
T2a | 35 (17.1%) |
T2b | 52 (25.3%) |
T2c | 58 (28.3%) |
T3a | 7 (3.4%) |
T3b | 8 (3.9%) |
≤ 6 7 | 60 (29.3%) 108 (52.7%) |
≥ 8 | 37 (17%) |
Median | 15 |
Range | 2–137 |
< 10 | 108 (52.7%) |
10–20 | 67 (32.7%) |
≥ 20 | 30 (14.6%) |
Low | 23 (11.2%) |
Intermediate | 120 (58.6%) |
High | 62 (30.2) |
No | 88 (42.9%) |
Short (≤ 6 months) | 61 (29.8%) |
Long (> 6 months) | 56 (27.3%) |
22 (10.7%) | |
37.5 Gy |
26 (12.7%) |
40 Gy | 179 (87.3%) |
Organ tissue | Grade 0 | Grade 1 | Grade 2 | Grade 3 | Grade 4 |
---|---|---|---|---|---|
No change | Increased frequency or change in quality of bowel habits not requiring medication/ rectal discomfort not requiring analgesics | Diarrhea requiring parasympatholytic drugs/mucous discharge not necessitating sanitary pads/rectal or abdominal pain requiring analgesics | Diarrhea requiring parenteral support/severe mucous or blood discharge necessitating sanitary pads/abdominal distention (flat plate radiograph demonstrates distended bowel loops) | Acute or subacute obstruction, fistula or perforation; GI bleeding requiring transfusion; abdominal pain or tenesmus requiring tube decompression or bowel diversion | |
No change | Frequency of urination or nocturia twice pretreatment habit/dysuria, urgency not requiring medication | Frequency of urination or nocturia that is less frequent than every hour. Dysuria, urgency, bladder spasm requiring local anesthetic | Frequency with urgency and nocturia hourly or more frequently/dysuria, pelvis pain or bladder spasm requiring regular, frequent narcotic/gross hematuria with/ without clot passage | Hematuria requiring transfusion/acute bladder obstruction not secondary to clot passage, ulceration, or necrosis |
Study | No. of patients | Dose | Grade 1–2 GU (%) | Grade ≥ 3 GU (%) | Grade 1–2 GI (%) | Grade ≥ 3 GI (%) |
---|---|---|---|---|---|---|
Madsen, 2007 |
40 | 6.7 Gy x 5 fx | 49 | 2.5 | 39 | 0 |
Katz, 2010 |
304 | 7/7.25 Gy x 5 fx | 79 | 0 | 78 | 0 |
Boike, 2011 |
45 | 9.5/10 Gy x 5 fx | 51 | 0 | 55 | 0 |
Freeman, 2011 |
41 | 7/7.25 Gy x 5 fx | 32 | 2.5 | 16 | 0 |
Jabarri, 2012 |
38 | 9.5 Gy x 4/2 fx | 71 | 0 | 32 | 0 |
McBride, 2012 |
45 | 7.5/7.25 Gy x 5 fx | 74 | 0 | 38 | 0 |
Loblaw, 2013 |
84 | 7 Gy x 5 fx | 88 | 1 | 77 | 0 |
Bolzicco, 2013 |
100 | 7 Gy x 5 fx | 46 | 0 | 45 | 0 |
Oliai, 2013 |
70 | 7–7.4 Gy x 5 fx | 63 | 4 | 26 | 3 |
Mantz, 2014 |
102 | 8 Gy x 5 fx | 58 | 2 | 0 | 0 |
Chen, 2014 |
100 | 7/7.25 Gy x 5 fx | 71 | 0 | 21 | 0 |
Anwar, 2016 |
50 | 10.5 9.5 Gy Gy x x 2 2 fx fx and boost | 85 | 0 | 52 | 0 |
Hannan, 2016 |
91 | 9–10 Gy x 5 fx | 70 | 0 | 58 | 2 |
Brand, 2019124 | 415 | 7.25 Gy x 5 fx | 78 | 3 | 63 | 1 |
1Widmark, 2019 |
589 | 6.1 Gy x 7 fx | 48 | 5 | 51 | 1 |
Present study | 205 | 7.5/8 Gy x 5 fx | 81 | 1.5 | 38 | 0 |
All studies | 2319 | Total Number dose: of 33.5fxs: -50 5–Gy 7 | 32–88 | 0–5 | 0–78 | 0–3 |
CTVpros | PTVpros | CTVpsv | PTVpsv | |
---|---|---|---|---|
Volume, cm3 (range) | 52.1 | 70.6 | 80.4 | 108.1 |
(15.9–134.7) | (25.1–166.6) | (30.8–208.5) | (45.4–259.3) | |
Dose coverage % (range) | 99.1 | 95.8 | 100 | 99.5 |
(94.7–100) | (88.8–99.9) | (97.6–100) | (95.2–100) |
Toxicity | Grade | Toxicity at the end of treatment N = 205 (%) | Toxicity 3 months after treatment N = 205 (%) |
---|---|---|---|
0 | 128 (62.4) | 195 (95) | |
Gastrointestinal | 1 2 | 65 (31.7) 12 (5.9) | 9 (4.5) 1 (0.5) |
3 | 0 (0) | 0 (0) | |
0 | 35 (17.1) | 153 (74.6) | |
Genitourinary | 1 2 | 63 (30.7) 104 (50.7) | 30 (14.7) 20 (9.7) |
3 | 3 (1.5) | 2 (1) |
Toxicity | Grade | Low risk N = 23 (%) | Intermediate risk N = 120 (%) | High risk N = 62 (%) |
---|---|---|---|---|
0 | 8 (35) | 83 (69) | 37 (60) | |
1 | 14 (61) | 29 (24) | 22 (35) | |
Gastrointestinal | ||||
2 | 1 (4) | 8 (7) | 3 (5) | |
3 | 0 (0) | 0 (0) | 0 (0) | |
0 | 1 (4) | 26 (74.6) | 8 (13) | |
1 | 10 (43) | 25 (14.7) | 28 (45) | |
Genitourinary | ||||
2 | 12 (54) | 66 (9.7) | 26 (42) | |
3 | 0 (0) | 3 (2) | 0 (0) |