Assessment of toxicity of elective pelvic lymph node irradiation in patients with high-risk prostate cancer

Kireeva T.A.; Gumenetskaya Yu.V.; Biryukov V.A.; Obukhov A.A.; Makarova K.S.; Strikanova I.A.; Dzhabrailova S.O.; Lepilina O.G.; Ivanov S.A.; Kaprin A.D.

doi:https://doi.org/10.17116/onkolog20221102120

Kireeva T.A.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

Gumenetskaya Yu.V.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

Biryukov V.A.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

SPIN RSCI: 3167-0076
Scopus AuthorID: 56699659300
ORCID: 0000-0002-6750-521X

Obukhov A.A.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

Makarova K.S.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

Strikanova I.A.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

Dzhabrailova S.O.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

Lepilina O.G.

A.F. Tsyb Medical Radiology Research Center — Branch of the National Medical Research Radiology Center of the Ministry of Health of Russia

Ivanov S.A.

Tsyb Medical Radiology Research Center

ORCID: 0000-0001-7689-6032

Kaprin A.D.

P.A. Herzen Moscow Oncology Research Institute — Branch of the National Medical Radiology Research Center of Ministry of Russia;
Peoples’ Friendship University of Russia

SPIN RSCI: 1759-8101
Scopus AuthorID: 6602709853
ResearcherID: K-1445-2014
ORCID: 0000-0001-8784-8415

Assessment of toxicity of elective pelvic lymph node irradiation in patients with high-risk prostate cancer

Authors:

Kireeva T.A., Gumenetskaya Yu.V., Biryukov V.A., Obukhov A.A., Makarova K.S., Strikanova I.A., Dzhabrailova S.O., Lepilina O.G., Ivanov S.A., Kaprin A.D.

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Journal: P.A. Herzen Journal of Oncology. 2022;11(2): 20‑24

DOI: 10.17116/onkolog20221102120

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To cite this article:

Kireeva TA, Gumenetskaya YuV, Biryukov VA, et al. . Assessment of toxicity of elective pelvic lymph node irradiation in patients with high-risk prostate cancer. P.A. Herzen Journal of Oncology. 2022;11(2):20‑24. (In Russ.)
https://doi.org/10.17116/onkolog20221102120

Подписка 2026 Онкология. Журнал им. П.А. Герцена (P.A. Herzen Journal of Oncology)

Использование инфографики авторами научных работ

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OBJECTIVE

To study the impact of elective pelvic lymph node irradiation on early results of the treatment and on quality of life in patients with high-risk prostate cancer.

MATERIAL AND METHODS

Combined modality radiotherapy with hormone therapy was performed in 60 patients with prostate cancer in MRRC, in the period from November, 2019 to January, 2021. The patients were randomized into 2 groups: with regional lymph node irradiation (n=32) and without irradiation (n=28). At the first stage of treatment, a course of conformal external beam radiotherapy (EBRT) was carried out in a total dose of 46 Gy. At the second stage of the treatment one session of high-dose-rate brachytherapy (192Ir) at a single dose of 15 Gy was performed.

RESULTS

Acute, grade 1 genitourinary (GU) toxicities occurred in 11 (34.4%) patients in the group with regional lymph node irradiation and in 8 (28.6%) patients in the group without additional irradiation (p .83). In group 2, one (3.6%) patient had GU toxicity of grade 2. Acute, grade 1 lower gastrointestinal (GI) toxicities were observed in 13 (40.6%) patients in the group with regional lymph node irradiation and in 3 (10.7%) patients in the group without additional irradiation (p=0.01).

CONCLUSIONS

The preliminary analysis showed an increase in the incidence of lower GI and GU toxicities in the group with elective regional lymph node irradiation.

Keywords:

prostate cancer

high risk

elective lymph node irradiation

dose escalation

radiation effects

combined modality radiotherapy

brachytherapy

Authors:

Kireeva T.A.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

Gumenetskaya Yu.V.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

Biryukov V.A.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

SPIN RSCI: 3167-0076
Scopus AuthorID: 56699659300
ORCID: 0000-0002-6750-521X

Obukhov A.A.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

Makarova K.S.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

Strikanova I.A.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

Dzhabrailova S.O.

A.F. Tsyb Medical Radiology Research Center — Branch National Medical Radiology Research Center of the Ministry of Health of Russia

Lepilina O.G.

A.F. Tsyb Medical Radiology Research Center — Branch of the National Medical Research Radiology Center of the Ministry of Health of Russia

Ivanov S.A.

Tsyb Medical Radiology Research Center

ORCID: 0000-0001-7689-6032

Kaprin A.D.

P.A. Herzen Moscow Oncology Research Institute — Branch of the National Medical Radiology Research Center of Ministry of Russia;
Peoples’ Friendship University of Russia

SPIN RSCI: 1759-8101
Scopus AuthorID: 6602709853
ResearcherID: K-1445-2014
ORCID: 0000-0001-8784-8415

Received:

26.07.2021

Accepted:

25.10.2021

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References:

Kaprin AD, Starinskiy VV, Shakhzadova AO, eds. Malignant tumors in Russia in 2019 (morbidity and mortality). M.: MNIOI im. P.A. Gertsena — filial FGBU «NMITs radiologii» Minzdrava Rossii; 2020. (In Russ.).
Kaprin AD, Starinskiy VV, Shakhzadova AO, eds. The state of oncological assistance to the population of Russia in 2019. M.: MNIOI im. P.A. Gertsena — filial FGBU «NMITs radiologii» Minzdrava Rossii; 2020. (In Russ.).
Kaprin AD, Kostin AA, Tsybul’sky AD. Qulity of life patients with locally advanced prostate cancer as a creterion effectiveness of treatment. Problems of Oncology=Voprosy Onkologii. 2009;55(3):285-290. (In Russ.).
Veliev EI, Okhrits VE, Obeid Akh. Prognostic factors of prostate cancer before and after radical prostatectomy. Cancer Urol. 2011;7(2):52-53. (In Russ.).
Knipper S, Palumbo C, Pecoraro A, Rosiello G, Tian Z, Briganti A, Kevin CZ, Fred Saad F, Tilki D, Graefen M, Pierre I, Karakiewicz PI. Survival outcomes of radical prostatectomy vs. external beam radiation therapy in prostate cancer patients with Gleason Score 9—10 at biopsy: A population-based analysis. Urol Oncol. 2020;38(3):79.e9-79.e14. https://doi.org/10.1016/j.urolonc.2019.09.015
Sandler KA, Cook RR, Ciezki JP, Ross AE, Pomerantz MM, Nguyen PL, Shaikh T, Tran PT, Stock RG, Merrick GS, et al. Clinical outcomes for patients with Gleason score 10 prostate adenocarcinoma: results from a multi-institutional consortium study. Int J Radiat Oncol Biol Phys. 2018;101(4):883-888. https://doi.org/10.1016/j.ijrobp.2018.03.060
Kishan AU, Cook RR, Ciezki JP, Ross AE, Pomerantz MM, Nguyen PL, Shaikh T, Tran PT, Sandler KA, Stock RG, et al. Radical prostatectomy, external beam radiotherapy, or external beam radiotherapy with brachytherapy boost and disease progression and mortality in patients with Gleason score 9—10 prostate cancer. JAMA. 2018;319(9):896-905. https://doi.org/10.1001/jama.2018.0587
Michalski JM, Moughan J, Purdy J, Bosch W, Bruner DW, Bahary JP, Lau H, Duclos M, Parliament M, Morton G, Hamstra D, Seider M, Lock MI, Patel M, Gay H, Vigneault E, Winter K, Sandler H. Effect of standard vs dose-escalated radiation therapy for patients with intermediate-risk prostate cancer: The NRG Oncology RTOG 0126 Randomized Clinical Trial. JAMA Oncol. 2018;4(6):1-9. https://doi.org/10.1001/jamaoncol.2018.0039
Dearnaley DP, Jovic G, Syndikus I, Khoo V, Cowan RA, Graham JD, Aird EG, Bottomley D, Huddart RA, Jose CC, Matthews JH, Millar JL, Murphy C, Russell JM, Scrase CD, Parmar MK, Sydes MR. Escalated-dose versus control-dose conformal radiotherapy for prostate cancer: long-term results from the MRC RT01 randomised controlled trial. Lancet Oncol. 2014;15(4):464-473. https://doi.org/10.1016/S1470-2045(14)70040-3
Shahid N, Loblaw A, Chung HT, Cheung P, Szumacher E, Danjoux C, Sankreacha R, Zhang L, Deabreu A, Mamedov A, Morton G. Long-term toxicity and health-related quality of life after single-fraction high dose rate brachytherapy boost and hypofractionated external beam radiotherapy for intermediate-risk prostate cancer. Clin Oncol (R Coll Radiol). 2017;29(7):412-420. https://doi.org/10.1016/j.clon.2017.01.042
William RP, Zelefsky MJ. Improving outcomes in high-risk prostate cancer with radiotherapy. Rep Pract Oncol Radiother. 2013;18(6):333-337. https://doi.org/10.1016/j.rpor.2013.10.006
Morozov SP, Bezrukov EA. Tomographic methods in prostate cancer evaluation. Russian Electronic Journal of Radiology = Rossiiskii elektronnyi zhurnal luchevoi diagnostiki. 2011;1(4):18-26. (In Russ.).
Roach M, Marquez C, Yuo HS, Narayan P, Coleman L, Nseyo UO, Navvab Z, Carroll PR. Predicting the risk of lymph node involvement using the pre-treatment prostate specific antigen and Gleason score in men with clinically localized prostate cancer. Int J Radiat Oncol Biol Phys. 1994;28(1):33-37. https://doi.org/10.1016/0360-3016(94)90138-4
NCCN Guidelines Version 2.2021. Prostate cancer, version 2.2021. https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf
Murthy V, Maitre P, Bhatia J, Kannan S, Krishnatry R, Prakash G, Bakshi G, Pal M, Menon S. Mahantshetty U. Late toxicity and quality of life with prostate only or whole pelvic radiation therapy in high risk prostate cancer (POP-RT): A randomised trial. Radiother Oncol. 2020;145:71-80. https://doi.org/10.1016/j.radonc.2019.12.006
Deville C, Both S, Hwang WT, Tochner Z, Vapiwala N. Clinical toxicities and dosimetric parameters after whole-pelvis versus prostate-only intensity-modulated radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2020;78(3):763-772. https://doi.org/10.1016/j.ijrobp.2009.08.043
Storey MR, Pollack A, Zagars G, Smith L, Antolak J, Rosen I. Complications from radiotherapy dose escalation in prostate cancer: preliminary results of a randomized trial. Int J Radiat Oncol Biol Phys. 2000;48(3):635-642. https://doi.org/10.1016/s0360-3016(00)00700-8
Roach M 3rd, DeSilvio M, Lawton C, Uhl V, Machtay M, Seider MJ, Rotman M, Jones C, Asbell SO, Valicenti RK, Han S, Thomas CR Jr, Shipley WS; Radiation Therapy Oncology Group 9413. Phase III trial comparing whole-pelvic versus prostate-only radiotherapy and neoadjuvant versus adjuvant combined androgen suppression. J Clin Oncol. 2003;21(10):1904-1911. https://doi.org/10.1200/jco.2003.05.004
Roach M 3rd, DeSilvio M, Valicenti R, Grignon D, Asbell SO, Lawton C, Thomas CR Jr, Shipley WU. Whole-pelvis, “mini-pelvis,” or prostate-only external beam radiotherapy after neoadjuvant and concurrent hormonal therapy in patients treated in the Radiation Therapy Oncology Group 9413 trial. Int J Radiat Oncol Biol Phys. 2006; 66(3):647-653. https://doi.org/10.1016/j.ijrobp.2006.05.074
Roach M, Moughan J, Lawton CAF, Dicker AP, Zeitzer KL, Gore EM, Kwok Y, Seider MJ, Hsu IC, Hartford AC, et al. Sequence of hormonal therapy and radiotherapy field size in unfavourable, localised prostate cancer (NRG/RTOG 9413): long-term results of a randomised, phase 3 trial. Lancet Oncol. 2018;19(11):1504-1515. https://doi.org/10.1016/s1470-2045(18)30528-x