• Barbara A Jereczek-Fossa, Dario Zerini, Cristiana Fodor, Luigi Santoro, Flavia Serafini, Raffaella Cambria, Andrea Vavassori, Federica Cattani, Cristina Garibaldi, Federica Gherardi, Annamaria Ferrari, Bernardo Rocco, Epifanio Scardino, Ottavio de Cobelli, and Roberto Orecchia.
• Department of Radiotherapy, European Institute of Oncology, Milan, Italy; University of Milan, Milan, Italy. barbara.jereczek@ieo.it
• Int. J. Radiat. Oncol. Biol. Phys. 2010 Sep 1; 78 (1): 26-34.

PurposeTo analyze the correlation between acute and late injury in 973 prostate cancer patients treated with radiotherapy and to evaluate the effect of patient-, tumor-, and treatment-related variables on toxicity.Methods And MaterialsOf the 973 patients, 542 and 431 received definitive or postprostatectomy radiotherapy, respectively. Three-dimensional conformal radiotherapy included a six-field technique and two-dynamic arc therapy. Toxicity was classified according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. The correlation between acute and late toxicity (incidence and severity) was assessed.ResultsMultivariate analysis showed that age 70 Gy (p = .014), and radiotherapy duration (p = .05) correlated with greater acute urinary toxicity. Acute rectal toxicity (p <.0001) was the only factor that correlated with late rectal injury on multivariate analysis. Late urinary toxicity correlated with acute urinary events (p <.0001) and was inversely related to the use of salvage radiotherapy (p = .018). A highly significant correlation was found between the incidence of acute and late events for both rectal (p <.001) and urinary (p <.001) reactions. The severity of acute toxicity (Grade 2 or greater) was predictive for the severity of late toxicity for both rectal and urinary events (p <.001).ConclusionThe results of our study have shown that the risk of acute reactions depends on both patient-related (age) and treatment-related (dose, technique) factors. Acute toxicity was an independent significant predictor of late toxicity. These findings might help to predict and prevent late radiotherapy-induced complications.Copyright (c) 2010 Elsevier Inc. All rights reserved.

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