A comparison of the acute toxicities using moderate hypo-fractionated intensity-modulated radiation therapy or volumetric modulated arc therapy for the treatment of early-stage prostate cancer

Aim: This study compared the acute toxicities reported during radiotherapy treatment using either intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT) to deliver a moderate hypo-fractionated treatment for early-stage prostate cancer. Material and methods: Acute toxicities are routinely reported at the clinical site for all patients using the Common Terminology Criteria for Adverse Events. Toxicity assessment is performed on day 1 of treatment, then once weekly thereafter. The recorded toxicities of 40 cases treated with five-field IMRT, and 32 cases treated using VMAT were retrospectively compared. All cases were prescribed 73.68 Gy in 28 fractions. Eight symptoms were assessed; diarrhoea, proctitis, fatigue, pain, dermatitis, urinary frequency, urinary retention and urinary tract pain. Results: In terms of the overall toxicity recorded, VMAT was shown to reduce the toxicities of dermatitis, fatigue, pain and urinary frequency (p<0.05). Using IMRT, grade 2 toxicities were reported for proctitis, pain, urinary frequency, urinary retention and urinary tract pain. Using VMAT, grade 2 toxicities were reported for urinary frequency and urinary retention. Findings: The research reported here is one of the first publications to demonstrate that VMAT is associated with decreased toxicities compared with IMRT for the treatment of early-stage prostate cancer.