Do Intermediate Radiation Doses Contribute to Late Rectal Toxicity? An Analysis of Data From Radiation Therapy Oncology Group Protocol 94-06
Purpose To investigate whether the volumes of rectum exposed to intermediate doses, from 30 to 50 Gy, contribute to the risk of Grade ≥2 late rectal toxicity among patients with prostate cancer receiving radiotherapy. Methods and Materials Data from 1009 patients treated on Radiation Therapy Oncolog...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2012-10, Vol.84 (2), p.390-395 |
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| creator | Tucker, Susan L., Ph.D Dong, Lei, Ph.D Michalski, Jeff M., M.D Bosch, Walter R., D.Sc Winter, Kathryn, M.S Cox, James D., M.D Purdy, James A., Ph.D Mohan, Radhe, Ph.D |
| description | Purpose To investigate whether the volumes of rectum exposed to intermediate doses, from 30 to 50 Gy, contribute to the risk of Grade ≥2 late rectal toxicity among patients with prostate cancer receiving radiotherapy. Methods and Materials Data from 1009 patients treated on Radiation Therapy Oncology Group protocol 94-06 were analyzed using three approaches. First, the contribution of intermediate doses to a previously published fit of the Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) model was determined. Next, the extent to which intermediate doses provide additional risk information, after taking the LKB model into account, was investigated. Third, the proportion of rectum receiving doses higher than a threshold, VDose, was computed for doses ranging from 5 to 85 Gy, and a multivariate Cox proportional hazards model was used to determine which of these parameters were significantly associated with time to Grade ≥2 late rectal toxicity. Results Doses |
| doi_str_mv | 10.1016/j.ijrobp.2011.11.073 |
| format | Article |
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An Analysis of Data From Radiation Therapy Oncology Group Protocol 94-06</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Tucker, Susan L., Ph.D ; Dong, Lei, Ph.D ; Michalski, Jeff M., M.D ; Bosch, Walter R., D.Sc ; Winter, Kathryn, M.S ; Cox, James D., M.D ; Purdy, James A., Ph.D ; Mohan, Radhe, Ph.D</creator><creatorcontrib>Tucker, Susan L., Ph.D ; Dong, Lei, Ph.D ; Michalski, Jeff M., M.D ; Bosch, Walter R., D.Sc ; Winter, Kathryn, M.S ; Cox, James D., M.D ; Purdy, James A., Ph.D ; Mohan, Radhe, Ph.D</creatorcontrib><description>Purpose To investigate whether the volumes of rectum exposed to intermediate doses, from 30 to 50 Gy, contribute to the risk of Grade ≥2 late rectal toxicity among patients with prostate cancer receiving radiotherapy. Methods and Materials Data from 1009 patients treated on Radiation Therapy Oncology Group protocol 94-06 were analyzed using three approaches. First, the contribution of intermediate doses to a previously published fit of the Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) model was determined. Next, the extent to which intermediate doses provide additional risk information, after taking the LKB model into account, was investigated. Third, the proportion of rectum receiving doses higher than a threshold, VDose, was computed for doses ranging from 5 to 85 Gy, and a multivariate Cox proportional hazards model was used to determine which of these parameters were significantly associated with time to Grade ≥2 late rectal toxicity. Results Doses <60 Gy had no detectable impact on the fit of the LKB model, as expected on the basis of the small estimate of the volume parameter ( n = 0.077). Furthermore, there was no detectable difference in late rectal toxicity among cohorts with similar risk estimates from the LKB model but with different volumes of rectum exposed to intermediate doses. The multivariate Cox proportional hazards model selected V75 as the only value of VDose significantly associated with late rectal toxicity. Conclusions There is no evidence from these data that intermediate doses influence the risk of Grade ≥2 late rectal toxicity. Instead, the critical doses for this endpoint seem to be ≥75 Gy. It is hypothesized that cases of Grade ≥2 late rectal toxicity occurring among patients with V75 less than approximately 12% may be due to a “background” level of risk, likely due mainly to biological factors.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2011.11.073</identifier><identifier>PMID: 22342302</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Background levels ; Biological and medical sciences ; DATA ANALYSIS ; Data processing ; Dose–volume histogram ; Gynecology. Andrology. Obstetrics ; HEALTH HAZARDS ; Hematology, Oncology and Palliative Medicine ; Humans ; Late rectal toxicity ; Male ; Male genital diseases ; Medical sciences ; Models, Statistical ; MULTIVARIATE ANALYSIS ; NEOPLASMS ; Nephrology. Urinary tract diseases ; Oncology ; Organs at Risk - radiation effects ; PATIENTS ; Proportional Hazards Models ; PROSTATE ; Prostate cancer ; Prostatic Neoplasms - radiotherapy ; Radiation ; RADIATION DOSES ; Radiation Injuries - pathology ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Radiotherapy Dosage ; RECTUM ; Rectum - radiation effects ; Risk ; RTOG ; Time Factors ; TOXICITY ; Tumors ; Tumors of the urinary system ; Urinary tract. Prostate gland</subject><ispartof>International journal of radiation oncology, biology, physics, 2012-10, Vol.84 (2), p.390-395</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c620t-4b4c38b7926b779276a4a91591725b7cc7734a75ac1b5f6e1dd72ce2b48c46793</citedby><cites>FETCH-LOGICAL-c620t-4b4c38b7926b779276a4a91591725b7cc7734a75ac1b5f6e1dd72ce2b48c46793</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2011.11.073$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26370002$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22342302$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22149511$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Tucker, Susan L., Ph.D</creatorcontrib><creatorcontrib>Dong, Lei, Ph.D</creatorcontrib><creatorcontrib>Michalski, Jeff M., M.D</creatorcontrib><creatorcontrib>Bosch, Walter R., D.Sc</creatorcontrib><creatorcontrib>Winter, Kathryn, M.S</creatorcontrib><creatorcontrib>Cox, James D., M.D</creatorcontrib><creatorcontrib>Purdy, James A., Ph.D</creatorcontrib><creatorcontrib>Mohan, Radhe, Ph.D</creatorcontrib><title>Do Intermediate Radiation Doses Contribute to Late Rectal Toxicity? An Analysis of Data From Radiation Therapy Oncology Group Protocol 94-06</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose To investigate whether the volumes of rectum exposed to intermediate doses, from 30 to 50 Gy, contribute to the risk of Grade ≥2 late rectal toxicity among patients with prostate cancer receiving radiotherapy. Methods and Materials Data from 1009 patients treated on Radiation Therapy Oncology Group protocol 94-06 were analyzed using three approaches. First, the contribution of intermediate doses to a previously published fit of the Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) model was determined. Next, the extent to which intermediate doses provide additional risk information, after taking the LKB model into account, was investigated. Third, the proportion of rectum receiving doses higher than a threshold, VDose, was computed for doses ranging from 5 to 85 Gy, and a multivariate Cox proportional hazards model was used to determine which of these parameters were significantly associated with time to Grade ≥2 late rectal toxicity. Results Doses <60 Gy had no detectable impact on the fit of the LKB model, as expected on the basis of the small estimate of the volume parameter ( n = 0.077). Furthermore, there was no detectable difference in late rectal toxicity among cohorts with similar risk estimates from the LKB model but with different volumes of rectum exposed to intermediate doses. The multivariate Cox proportional hazards model selected V75 as the only value of VDose significantly associated with late rectal toxicity. Conclusions There is no evidence from these data that intermediate doses influence the risk of Grade ≥2 late rectal toxicity. Instead, the critical doses for this endpoint seem to be ≥75 Gy. It is hypothesized that cases of Grade ≥2 late rectal toxicity occurring among patients with V75 less than approximately 12% may be due to a “background” level of risk, likely due mainly to biological factors.</description><subject>Background levels</subject><subject>Biological and medical sciences</subject><subject>DATA ANALYSIS</subject><subject>Data processing</subject><subject>Dose–volume histogram</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>HEALTH HAZARDS</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Late rectal toxicity</subject><subject>Male</subject><subject>Male genital diseases</subject><subject>Medical sciences</subject><subject>Models, Statistical</subject><subject>MULTIVARIATE ANALYSIS</subject><subject>NEOPLASMS</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Oncology</subject><subject>Organs at Risk - radiation effects</subject><subject>PATIENTS</subject><subject>Proportional Hazards Models</subject><subject>PROSTATE</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Radiation</subject><subject>RADIATION DOSES</subject><subject>Radiation Injuries - pathology</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy Dosage</subject><subject>RECTUM</subject><subject>Rectum - radiation effects</subject><subject>Risk</subject><subject>RTOG</subject><subject>Time Factors</subject><subject>TOXICITY</subject><subject>Tumors</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. Prostate gland</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkl2LEzEUhgdR3Lr6D0QCIngzNV8z6dwoS-uuC4UVreBdyKSpmzrNGZOMOP_BH-0ZWz_wRjjkhOTJSd68pygeMzpnlNUv9nO_j9D2c04Zm2NQJe4UM7ZQTSmq6uPdYkZFTUuB8FnxIKU9pUgqeb8441xILiifFd9XQK5DdvHgtt5kR96ZKXsIZAXJJbKEkKNvB9zKQNY_EWez6cgGvnnr8_iKXAQM043JJwI7sjLZkMsIh7-KbW5dNP1IboKFDj6N5CrC0JO3ETLgCmlkSeuHxb2d6ZJ7dMrnxYfL15vlm3J9c3W9vFiXtuY0l7KVVixa1fC6VTiq2kjTsKphiletslYpIY2qjGVttasd224Vt463cmFlrRpxXjw91oWUvU4owtlbCyGgMM05k03FGFLPj1Qf4cvgUtYHn6zrOhMcDEkzLhYM2YVAVB5RGyGl6Ha6j_5g4qgZ1ZNbeq-PbunJLY2BbuGxJ6cbhhb___ehX_Yg8OwEmGRNt4smWJ_-cLVQaOrEvTxyDn_tq3dxEuWCRU_jpGkL_n8v-beA7XzweOdnN7q0hyGiwahZJ66pfj911tRYjOFMsEr8AMSqyBk</recordid><startdate>20121001</startdate><enddate>20121001</enddate><creator>Tucker, Susan L., Ph.D</creator><creator>Dong, Lei, Ph.D</creator><creator>Michalski, Jeff M., M.D</creator><creator>Bosch, Walter R., D.Sc</creator><creator>Winter, Kathryn, M.S</creator><creator>Cox, James D., M.D</creator><creator>Purdy, James A., Ph.D</creator><creator>Mohan, Radhe, Ph.D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>OTOTI</scope></search><sort><creationdate>20121001</creationdate><title>Do Intermediate Radiation Doses Contribute to Late Rectal Toxicity? An Analysis of Data From Radiation Therapy Oncology Group Protocol 94-06</title><author>Tucker, Susan L., Ph.D ; Dong, Lei, Ph.D ; Michalski, Jeff M., M.D ; Bosch, Walter R., D.Sc ; Winter, Kathryn, M.S ; Cox, James D., M.D ; Purdy, James A., Ph.D ; Mohan, Radhe, Ph.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c620t-4b4c38b7926b779276a4a91591725b7cc7734a75ac1b5f6e1dd72ce2b48c46793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Background levels</topic><topic>Biological and medical sciences</topic><topic>DATA ANALYSIS</topic><topic>Data processing</topic><topic>Dose–volume histogram</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>HEALTH HAZARDS</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Late rectal toxicity</topic><topic>Male</topic><topic>Male genital diseases</topic><topic>Medical sciences</topic><topic>Models, Statistical</topic><topic>MULTIVARIATE ANALYSIS</topic><topic>NEOPLASMS</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Oncology</topic><topic>Organs at Risk - radiation effects</topic><topic>PATIENTS</topic><topic>Proportional Hazards Models</topic><topic>PROSTATE</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Radiation</topic><topic>RADIATION DOSES</topic><topic>Radiation Injuries - pathology</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy Dosage</topic><topic>RECTUM</topic><topic>Rectum - radiation effects</topic><topic>Risk</topic><topic>RTOG</topic><topic>Time Factors</topic><topic>TOXICITY</topic><topic>Tumors</topic><topic>Tumors of the urinary system</topic><topic>Urinary tract. Prostate gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tucker, Susan L., Ph.D</creatorcontrib><creatorcontrib>Dong, Lei, Ph.D</creatorcontrib><creatorcontrib>Michalski, Jeff M., M.D</creatorcontrib><creatorcontrib>Bosch, Walter R., D.Sc</creatorcontrib><creatorcontrib>Winter, Kathryn, M.S</creatorcontrib><creatorcontrib>Cox, James D., M.D</creatorcontrib><creatorcontrib>Purdy, James A., Ph.D</creatorcontrib><creatorcontrib>Mohan, Radhe, Ph.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tucker, Susan L., Ph.D</au><au>Dong, Lei, Ph.D</au><au>Michalski, Jeff M., M.D</au><au>Bosch, Walter R., D.Sc</au><au>Winter, Kathryn, M.S</au><au>Cox, James D., M.D</au><au>Purdy, James A., Ph.D</au><au>Mohan, Radhe, Ph.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Do Intermediate Radiation Doses Contribute to Late Rectal Toxicity? An Analysis of Data From Radiation Therapy Oncology Group Protocol 94-06</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2012-10-01</date><risdate>2012</risdate><volume>84</volume><issue>2</issue><spage>390</spage><epage>395</epage><pages>390-395</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>Purpose To investigate whether the volumes of rectum exposed to intermediate doses, from 30 to 50 Gy, contribute to the risk of Grade ≥2 late rectal toxicity among patients with prostate cancer receiving radiotherapy. Methods and Materials Data from 1009 patients treated on Radiation Therapy Oncology Group protocol 94-06 were analyzed using three approaches. First, the contribution of intermediate doses to a previously published fit of the Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) model was determined. Next, the extent to which intermediate doses provide additional risk information, after taking the LKB model into account, was investigated. Third, the proportion of rectum receiving doses higher than a threshold, VDose, was computed for doses ranging from 5 to 85 Gy, and a multivariate Cox proportional hazards model was used to determine which of these parameters were significantly associated with time to Grade ≥2 late rectal toxicity. Results Doses <60 Gy had no detectable impact on the fit of the LKB model, as expected on the basis of the small estimate of the volume parameter ( n = 0.077). Furthermore, there was no detectable difference in late rectal toxicity among cohorts with similar risk estimates from the LKB model but with different volumes of rectum exposed to intermediate doses. The multivariate Cox proportional hazards model selected V75 as the only value of VDose significantly associated with late rectal toxicity. Conclusions There is no evidence from these data that intermediate doses influence the risk of Grade ≥2 late rectal toxicity. Instead, the critical doses for this endpoint seem to be ≥75 Gy. It is hypothesized that cases of Grade ≥2 late rectal toxicity occurring among patients with V75 less than approximately 12% may be due to a “background” level of risk, likely due mainly to biological factors.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22342302</pmid><doi>10.1016/j.ijrobp.2011.11.073</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Background levels Biological and medical sciences DATA ANALYSIS Data processing Dose–volume histogram Gynecology. Andrology. Obstetrics HEALTH HAZARDS Hematology, Oncology and Palliative Medicine Humans Late rectal toxicity Male Male genital diseases Medical sciences Models, Statistical MULTIVARIATE ANALYSIS NEOPLASMS Nephrology. Urinary tract diseases Oncology Organs at Risk - radiation effects PATIENTS Proportional Hazards Models PROSTATE Prostate cancer Prostatic Neoplasms - radiotherapy Radiation RADIATION DOSES Radiation Injuries - pathology Radiology RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Radiotherapy Dosage RECTUM Rectum - radiation effects Risk RTOG Time Factors TOXICITY Tumors Tumors of the urinary system Urinary tract. Prostate gland |
| title | Do Intermediate Radiation Doses Contribute to Late Rectal Toxicity? An Analysis of Data From Radiation Therapy Oncology Group Protocol 94-06 |
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