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Rectal Dose Constraints for Intensity Modulated Radiation Therapy of the Prostate

Swanson, Gregory P., MD; Stathakis, Sotirios, PhD

American Journal of Clinical Oncology: April 2011 - Volume 34 - Issue 2 - p 188-195
doi: 10.1097/COC.0b013e3181dbb993
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Prostate dose escalation appears to have resulted in increased cancer control. Such escalation has been made possible by the ability to deliver more conformal treatment that spares normal tissue from the higher radiation doses. The supposition is that this has enabled higher doses, but without an increase in toxicity. The most disabling toxicity in prostate cancer radiotherapy is rectal. We evaluated the current status of conformal radiation and late rectal toxicity with the goal of determining whether reasonable rectal dose and volume constraints can be determined. Although the literature is inexact, we believe that some generalized constraints can be recommended and show that those recommendations are consistent with what is being used at experienced centers.

From the Department of Radiation Oncology, University of Texas Health Science Center, San Antonio, TX.

Reprints: Sotirios Stathakis, PhD, Department of Radiation Oncology, University of Texas Health Science Center, San Antonio, TX 78229. E-mail: Stathakis@uthscsa.edu.

© 2011 Lippincott Williams & Wilkins, Inc.