ABSTRACTS OF THE 21st ANNUAL MEETING OF THE ITALIAN ...

in either group showed >G2 acute intestinal or urological
toxicity. Among Group 1 patients, 32 (44.4%) had no urinary
toxicity and 40 (55.6%) had G1-G2 urinary toxicity; 51
patients (51.8%) had no rectal toxicity and 21 (29.2%) had
G1-G2 rectal toxicity. Among Group 2 patients, 9 (31%) had
G0 urinary toxicity and 20 (69%) had G1-G2 urinary toxicity;
25 patients (86.2%) had G0 rectal toxicity and 4 patients
(13.8%) had G1-G2 rectal toxicity. There was no significant
correlation between acute urinary or rectal toxicity and the age
of patients (p=0.43 and p=0.269, respectively) under bivariate
analysis. There was no significant correlation for acute
intestinal and urological toxicity under multivariate analysis.
Discussion and Conclusion: Radical radiotherapy for localized
prostate carcinoma is an effective treatment option in elderly
patients. This analysis demonstrates that age has no significant
impact on radiation-induced intestinal and urological acute
toxicity and can be safely used as curative treatment for
prostate cancer patients older than 75 years.
171
HYPOFRACTIONATED IG-IMRT AND ACUTE
TOXICITY IN PROSTATE CANCER: THE
EXPERIENCE OF THE DEPARTMENT OF
RADIOTHERAPY SANT’ORSOLA-MALPIGHI
HOSPITAL, BOLOGNA
Mirko Mazza1 , Antonio Malorgio1 , Feisal Bunkheila1 ,
Silvia Cammelli1 , Maria Ntreta1 , Annalisa Angelini1 ,
Alessandro Bertaccini2 , Renzo Mazzarotto1 and Enza Barbieri1 1Istituto di Radioterapia and 2Clinica Urologica Policlinico
S. Orsola-Malpighi, Bologna, Italy
Background: In recent years, image-guided radiation therapy
(IGRT) has taken a leading role in prostate cancer treatment,
allowing optimization of the target irradiation technique
through the use of the intensity-modulated radiation therapy
(IMRT) supplied in a hypofractionated regime. The endpoint is
to improve patient outcome, both in terms of local control of
the disease and in terms of reduction of radiotherapy toxicity.
Aim: The aim of this study was to provide preliminary data of
our experience related to gastrointestinal (GI) and
genitourinary (GU) toxicity profiles of those patients who have
completed this treatment. Patients and Methods: Between
October 2010 and February 2011, 18 patients affected by
intermediate- to high-risk prostate cancer have been treated at
the Radiotherapy Department of Policlinico S. Orsola-
Malpighi of Bologna. The placement of three gold fiducial
markers inside the prostatic gland was planned first by the use
of ultrasound guidance, and then, after two to three weeks,
computed tomography and magnetic resonance imaging. The
total dose delivered to clinical target was 67.5 Gy (25 fractions
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ANTICANCER RESEARCH 31: 1807-1956 (2011)
of 2.7 Gy each). Results: Acute toxicity was evaluated during
treatment through the use of the EORTC-RTOG toxicity
grading scale with the following results. GI toxicity: 15
patients G0, 3 patients G1. GU toxicity: 13 patients G0, 5
patients G1. Conclusion: Although this study did not include
a sufficiently meaningful number of patients, it is possible to
conclude that the hypofractionated regime with IG-IMRT is a
very well tolerated treatment.
172
HIGH-DOSE CURATIVE RADIOTHERAPY
FOR PROSTATE CANCER: RECTAL
DOSE-VOLUME CONSTRAINTS AND
ACUTE INTESTINAL TOXICITY
Angelo Errico1 , Michele Battaglia2 , Annalisa Natuno1 ,
Maria Paola Ciliberti1 , Dora Di Cosmo1 , Giuseppe Squeo1 ,
Stefania Carbone1 , Pierangela Nardella3 , Nicola Caretto4 ,
Francesco Lafranceschina2 , Francesco Paolo Selvaggi2 and Santa Bambace1 1U.O.C Radioterapia Oncologica and 4U.O.C. Fisica
Sanitaria, Ospedale “R. Dimiccoli”, Barletta, Italy;
2Urologia Universitaria I-Policlinico di Bari, Italy;
3Istituto di Igiene, Università Cattolica del Sacro Cuore,
Roma, Italy
Aim: To assess the impact of rectal dose-volume constraint on
acute gastrointestinal (GI) toxicity in patients with nonmetastatic
localized and locally advanced prostate cancer
treated with high-dose curative radiotherapy. Patients and
Methods: Between June 2008 and May 2010, 101 patients
with prostate cancer received conventionally fractionated
three-dimensional conformal radiotherapy in our institution.
For intermediate- and high-risk patients, total dose to the
prostate ranged from 78 Gy to 80 Gy (2 Gy/fraction) and total
dose to the seminal vesicles ranged from 64 Gy to 70 Gy. No
patient received pelvic lymph node irradiation. Low-risk
patients (eight patients) received 80 Gy to the prostate and the
base of seminal vesicles. The median age of the patients was
73 (range 51-81) years. The median PSA was 9.3 (range 0.89-
89.3) ng/ml and 31% of patients had Gleason score (GS) ≤6,
32% of patients had GS=7 and 37% of patients had GS≥8.
Almost all patients (91%) received hormonotherapy before
and during radiotherapy. GI toxicity was assessed weekly
according to the RTOG toxicity scale. The complete rectal
wall, from the rectosigmoid flexure to the anal verge, was
contoured as an organ at risk. An empty rectum (rectal volume
55% nor V70>25%. We retrospectively re-assessed our
data according to the recent constraints proposed by the