Urethral and bladder dosimetry and urinary toxicity in prostate cancer patients undergoing SBRT with and without intra-prostatic boost
Background and purpose: To evaluate the dosimetric and toxicity profiles of stereotactic body radiotherapy (SBRT) for prostate cancer, comparing cohorts with and without intraprostatic boost (IPB) to assess feasibility and safety of IPB, with particular attention to urethral and bladder dose and tox...
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Elsevier
2025-09-01
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| Series: | Clinical and Translational Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630825000850 |
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| author | Nisha Bhargava Martina Hurwitz Josephine Levey Lily Bennett Joseph A. Aronovitz Daniel R. Schmidt Jonathan W. Lischalk Irving D. Kaplan Nima Aghdam |
| author_facet | Nisha Bhargava Martina Hurwitz Josephine Levey Lily Bennett Joseph A. Aronovitz Daniel R. Schmidt Jonathan W. Lischalk Irving D. Kaplan Nima Aghdam |
| author_sort | Nisha Bhargava |
| collection | DOAJ |
| description | Background and purpose: To evaluate the dosimetric and toxicity profiles of stereotactic body radiotherapy (SBRT) for prostate cancer, comparing cohorts with and without intraprostatic boost (IPB) to assess feasibility and safety of IPB, with particular attention to urethral and bladder dose and toxicity. Materials and methods: This retrospective cohort study analyzed 349 patients with localized prostate cancer treated between 2018 and 2023. Of these, 266 received SBRT with IPB, and 83 received SBRT without IPB. Patients were treated using a robotic SBRT platform with fiducial tracking. Dosimetric parameters for the urethra, including D0.03cc, D0.3cc, and V40Gy, and for the bladder, including D0.03cc, D5cc, D10cc, and V37Gy, were evaluated. Acute and late toxicities were assessed using CTCAE criteria. Results: For the urethra, median values for D0.03cc, D0.3cc, and V40Gy, and for the bladder, median values D0.03cc, D5cc, D10cc, and V37Gy were compared and no statistically significant differences were observed between the two cohorts. Late urinary toxicity of grade 3 or higher occurred in 2.25 % of patients in the IPB group and 2.47 % in the no IPB group, with no grade 3 acute toxicities reported. Discussion: These findings support the use of SBRT using an IPB as a feasible and safe approach to achieve focal dose escalation to dominant intra-prostatic lesions (DILs) without significantly increasing urethra or bladder dose or toxicity. Future research should focus on standardizing DIL contouring, exploring adaptive planning techniques to increase accuracy, and prospectively studying toxicity and quality of life in patients treated with IPB with SBRT. |
| format | Article |
| id | doaj-art-e6bdc2d390a845538f00c03ff56829e4 |
| institution | DOAJ |
| issn | 2405-6308 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj-art-e6bdc2d390a845538f00c03ff56829e42025-08-20T02:55:20ZengElsevierClinical and Translational Radiation Oncology2405-63082025-09-015410099310.1016/j.ctro.2025.100993Urethral and bladder dosimetry and urinary toxicity in prostate cancer patients undergoing SBRT with and without intra-prostatic boostNisha Bhargava0Martina Hurwitz1Josephine Levey2Lily Bennett3Joseph A. Aronovitz4Daniel R. Schmidt5Jonathan W. Lischalk6Irving D. Kaplan7Nima Aghdam8Department of Radiation Oncology, Beth Israel Deaconess Medical Center Boston, MA, USADepartment of Radiation Oncology Brigham and Women’s Hospital at Boston, Weymouth MA USADepartment of Radiation Oncology, Beth Israel Deaconess Medical Center Boston, MA, USADepartment of Radiation Oncology, Beth Israel Deaconess Medical Center Boston, MA, USADepartment of Radiation Oncology, Beth Israel Deaconess Medical Center Boston, MA, USADepartment of Radiation Oncology, Beth Israel Deaconess Medical Center Boston, MA, USADepartment of Radiation Medicine, MedStar-Georgetown University Hospital, Washington, DC, USADepartment of Radiation Oncology, Beth Israel Deaconess Medical Center Boston, MA, USADepartment of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Hospital-Long Island, New York, NY, USA; NYCyberknife at Perlmutter Cancer Center -Manhattan, New York, NY, USA; Corresponding author at: 150 Amsterdam Avenue, New York, NY 10023, USA.Background and purpose: To evaluate the dosimetric and toxicity profiles of stereotactic body radiotherapy (SBRT) for prostate cancer, comparing cohorts with and without intraprostatic boost (IPB) to assess feasibility and safety of IPB, with particular attention to urethral and bladder dose and toxicity. Materials and methods: This retrospective cohort study analyzed 349 patients with localized prostate cancer treated between 2018 and 2023. Of these, 266 received SBRT with IPB, and 83 received SBRT without IPB. Patients were treated using a robotic SBRT platform with fiducial tracking. Dosimetric parameters for the urethra, including D0.03cc, D0.3cc, and V40Gy, and for the bladder, including D0.03cc, D5cc, D10cc, and V37Gy, were evaluated. Acute and late toxicities were assessed using CTCAE criteria. Results: For the urethra, median values for D0.03cc, D0.3cc, and V40Gy, and for the bladder, median values D0.03cc, D5cc, D10cc, and V37Gy were compared and no statistically significant differences were observed between the two cohorts. Late urinary toxicity of grade 3 or higher occurred in 2.25 % of patients in the IPB group and 2.47 % in the no IPB group, with no grade 3 acute toxicities reported. Discussion: These findings support the use of SBRT using an IPB as a feasible and safe approach to achieve focal dose escalation to dominant intra-prostatic lesions (DILs) without significantly increasing urethra or bladder dose or toxicity. Future research should focus on standardizing DIL contouring, exploring adaptive planning techniques to increase accuracy, and prospectively studying toxicity and quality of life in patients treated with IPB with SBRT.http://www.sciencedirect.com/science/article/pii/S2405630825000850Prostatic neoplasmsStereotactic body radiation therapyDominant intraprostatic lesionFocal dose escalationUrinary toxicityUrethral dose constraint |
| spellingShingle | Nisha Bhargava Martina Hurwitz Josephine Levey Lily Bennett Joseph A. Aronovitz Daniel R. Schmidt Jonathan W. Lischalk Irving D. Kaplan Nima Aghdam Urethral and bladder dosimetry and urinary toxicity in prostate cancer patients undergoing SBRT with and without intra-prostatic boost Clinical and Translational Radiation Oncology Prostatic neoplasms Stereotactic body radiation therapy Dominant intraprostatic lesion Focal dose escalation Urinary toxicity Urethral dose constraint |
| title | Urethral and bladder dosimetry and urinary toxicity in prostate cancer patients undergoing SBRT with and without intra-prostatic boost |
| title_full | Urethral and bladder dosimetry and urinary toxicity in prostate cancer patients undergoing SBRT with and without intra-prostatic boost |
| title_fullStr | Urethral and bladder dosimetry and urinary toxicity in prostate cancer patients undergoing SBRT with and without intra-prostatic boost |
| title_full_unstemmed | Urethral and bladder dosimetry and urinary toxicity in prostate cancer patients undergoing SBRT with and without intra-prostatic boost |
| title_short | Urethral and bladder dosimetry and urinary toxicity in prostate cancer patients undergoing SBRT with and without intra-prostatic boost |
| title_sort | urethral and bladder dosimetry and urinary toxicity in prostate cancer patients undergoing sbrt with and without intra prostatic boost |
| topic | Prostatic neoplasms Stereotactic body radiation therapy Dominant intraprostatic lesion Focal dose escalation Urinary toxicity Urethral dose constraint |
| url | http://www.sciencedirect.com/science/article/pii/S2405630825000850 |
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