Comparison of radiation side-effects of conformal and conventional radiotherapy in prostate cancer: a randomised trial

摘要: Summary Background Radical radiotherapy is commonly used to treat localised prostate cancer. Late chronic side-effects limit the dose that can be given, and may linked volume of normal tissues irradiated. Conformal allows a smaller amount rectum bladder treated, by shaping high-dose prostate. We assessed ability this new technology lessen risk radiation-related effects in randomised controlled trial conformal versus conventional radiotherapy. Methods recruited men with cancer for treatment standard 64 Gy daily 2 fractions. The were randomly assigned or treatment. primary endpoint was development late radiation complications (>3 months after treatment) measured Radiation Therapy Oncology Group (RTOG) score. Indicators disease (cancer) control also recorded. Findings In 225 significantly fewer developed radiation-induced proctitis bleeding group than (37 vs 56% ≥RTOG grade 1, p=0·004; 5 15% 2, p=0·01). There no differences between groups function (53 59% ≥grade p=0·34; 20 23% p=0·61). After median follow-up 3·6 years there significant difference local tumour (conformal 78% [95% CI 66–86], 83% [69–90]). Interpretation techniques lowered Widespread introduction these methods appropriate. Our results are basis dose-escalation studies improve control.