Buettner, F., Gulliford, S. L., Webb, S., Sydes, M. R., Dearnaley, D. P., Partridge, M. (2012) The dose-response of the anal sphincter region - An analysis of data from the MRC RT01 trial. RADIOTHERAPY AND ONCOLOGY, 103 (3). pp. 347-352. ISSN 0167-8140

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Abstract

Purpose: Most studies investigating the dose-response of the rectum focus on rectal bleeding. However, it has been reported that other symptoms such as urgency or sphincter control have a large impact on quality-of-life and that different symptoms are related to the dose to different parts of the anorectal wall. In this study correlations between the 3D dose distribution to the anal-sphincter region and radiation-induced side-effects were quantified. Materials and methods: Dose-surface maps of the anal canal were generated. Next, longitudinal and lateral extent and eccentricity were calculated at different dose levels; DSHs and DVHs were also determined. Correlations between these dosimetric measures and seven clinically relevant endpoints were determined by assessing dosimetric constraints. Furthermore, an LKB model was generated. The study was performed using the data of 388 prostate patients from the RT01 trial (ISRCTN 47772397). Results: Subjective sphincter control was significantly correlated with the dose to the anal surface. The strongest correlations were found for lateral extent at 53 Gy (p = 0.01). Outcome was also significantly correlated with the DSH and the mean dose to the anal surface. Conclusions: The dose to the anal sphincter region should be taken into account when generating treatment-plans. This could be done using shape-based tools, DSH/DVH-based tools or an NTCP model. (C) 2012 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 103 (2012) 347-352

Item Type:	Article
Authors (ICR Faculty only):	Webb, Steve and Partridge, Mike and Dearnaley, David
All Authors:	Buettner, F., Gulliford, S. L., Webb, S., Sydes, M. R., Dearnaley, D. P., Partridge, M.
Additional Information:	ISI Document Delivery No.: 966NP Times Cited: 0 Cited Reference Count: 33 Buettner, Florian Gulliford, Sarah L. Webb, Steve Sydes, Matthew R. Dearnaley, David P. Partridge, Mike Nhs We acknowledge NHS funding to the NIHR Biomedical Research Centre. Elsevier ireland ltd Clare
Uncontrolled Keywords:	Prostate cancer Radiotherapy Anal sphincter Dose-effect relation randomized controlled-trial late rectal toxicity localized prostate-cancer conformal radiotherapy radiation-therapy wall volume predictors symptoms impact
Research teams:	ICR divisions > Radiotherapy and Imaging > Radiotherapy Physics Modelling ICR divisions > Radiotherapy and Imaging > Clinical Academic Radiotherapy (Dearnaley) ICR divisions > Radiotherapy and Imaging > Radiotherapy Physics Functional Imaging
Depositing User:	Alexander Smithson
Date Deposited:	27 Jul 2012 10:29
Last Modified:	27 Jul 2012 10:29
URI:	http://publications.icr.ac.uk/id/eprint/11793

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