TY - JOUR
T1 - Accumulated bladder wall dose is correlated with patient-reported acute urinary toxicity in prostate cancer patients treated with stereotactic, daily adaptive MR-guided radiotherapy
AU - Willigenburg, Thomas
AU - van der Velden, Joanne M.
AU - Zachiu, Cornel
AU - Teunissen, Frederik R.
AU - Lagendijk, Jan J.W.
AU - Raaymakers, Bas W.
AU - de Boer, Johannes C.J.
AU - van der Voort van Zyp, Jochem R.N.
N1 - Funding Information:
This research has been partly funded by ZonMw IMDI/LSH-TKI Foundation (The Netherlands, project number 104006004). The funding sources were not involved in the design of the study, the collection, analysis, and interpretation of the data, nor in the writing and decision to submit the article for publication.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/6
Y1 - 2022/6
N2 - Background and purpose: Magnetic resonance (MR)-guided linear accelerators (MR-Linac) enable accurate estimation of delivered doses through dose accumulation using daily MR images and treatment plans. We aimed to assess the association between the accumulated bladder (wall) dose and patient-reported acute urinary toxicity in prostate cancer (PCa) patients treated with stereotactic body radiation therapy (SBRT). Materials and methods: One-hundred-and-thirty PCa patients treated on a 1.5 T MR-Linac were included. Patients filled out International Prostate Symptom Scores (IPSS) questionnaires at baseline, 1 month, and 3 months post-treatment. Deformable image registration-based dose accumulation was performed to reconstruct the delivered dose. Dose parameters for both bladder and bladder wall were correlated with a clinically relevant increase in IPSS (≥ 10 points) and/or start of alpha-blockers within 3 months using logistic regression. Results: Thirty-nine patients (30%) experienced a clinically relevant IPSS increase and/or started with alpha-blockers. Bladder D5cm3, V10–35Gy (in %), and Dmean and Bladder wall V10–35Gy (cm3 and %) and Dmean were correlated with the outcome (odds ratios 1.04–1.33, p-values 0.001–0.044). Corrected for baseline characteristics, bladder V10–35Gy (in %) and Dmean and bladder wall V10–35Gy (cm3 and %) and Dmean were still correlated with the outcome (odds ratios 1.04–1.30, p-values 0.001–0.028). Bladder wall parameters generally showed larger AUC values. Conclusion: This is the first study to assess the correlation between accumulated bladder wall dose and patient-reported urinary toxicity in PCa patients treated with MR-guided SBRT. The dose to the bladder wall is a promising parameter for prediction of patient-reported urinary toxicity and therefore warrants prospective validation and consideration in treatment planning.
AB - Background and purpose: Magnetic resonance (MR)-guided linear accelerators (MR-Linac) enable accurate estimation of delivered doses through dose accumulation using daily MR images and treatment plans. We aimed to assess the association between the accumulated bladder (wall) dose and patient-reported acute urinary toxicity in prostate cancer (PCa) patients treated with stereotactic body radiation therapy (SBRT). Materials and methods: One-hundred-and-thirty PCa patients treated on a 1.5 T MR-Linac were included. Patients filled out International Prostate Symptom Scores (IPSS) questionnaires at baseline, 1 month, and 3 months post-treatment. Deformable image registration-based dose accumulation was performed to reconstruct the delivered dose. Dose parameters for both bladder and bladder wall were correlated with a clinically relevant increase in IPSS (≥ 10 points) and/or start of alpha-blockers within 3 months using logistic regression. Results: Thirty-nine patients (30%) experienced a clinically relevant IPSS increase and/or started with alpha-blockers. Bladder D5cm3, V10–35Gy (in %), and Dmean and Bladder wall V10–35Gy (cm3 and %) and Dmean were correlated with the outcome (odds ratios 1.04–1.33, p-values 0.001–0.044). Corrected for baseline characteristics, bladder V10–35Gy (in %) and Dmean and bladder wall V10–35Gy (cm3 and %) and Dmean were still correlated with the outcome (odds ratios 1.04–1.30, p-values 0.001–0.028). Bladder wall parameters generally showed larger AUC values. Conclusion: This is the first study to assess the correlation between accumulated bladder wall dose and patient-reported urinary toxicity in PCa patients treated with MR-guided SBRT. The dose to the bladder wall is a promising parameter for prediction of patient-reported urinary toxicity and therefore warrants prospective validation and consideration in treatment planning.
KW - Bladder wall
KW - Dose accumulation
KW - MR-guided radiotherapy
KW - Prostate cancer
KW - SBRT
KW - Urinary toxicity
UR - http://www.scopus.com/inward/record.url?scp=85129668626&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2022.04.022
DO - 10.1016/j.radonc.2022.04.022
M3 - Article
C2 - 35489444
AN - SCOPUS:85129668626
SN - 0167-8140
VL - 171
SP - 182
EP - 188
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
ER -