Journal Article

DKFZ-2025-01480

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Dose-response mapping of bladder and rectum in prostate cancer patients undergoing radiotherapy with and without baseline toxicity correction.

Puri, T. ; Rancati, T. ; Seibold, P.DKFZ* ; Webb, A. ; Osorio, E. V. ; Green, A. ; Gioscio, E. ; Azria, D. ; Farcy-Jacquet, M.-P. ; Chang-Claude, J.DKFZ* ; Dunning, A. ; Lambrecht, M. ; Avuzzi, B. ; de Ruysscher, D. ; Sperk, E. ; Vega, A. ; Veldeman, L. ; Rosenstein, B. ; Shortall, J. ; Kerns, S. ; Talbot, C. ; Morris, A. P. ; McWilliam, A. ; Hoskin, P. ; Choudhury, A. ; West, C. ; van Herk, M. ; Consortium, R. (Collaboration Author)

2025
Elsevier Science Amsterdam [u. a.]

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Please use a persistent id in citations: doi:10.1016/j.phro.2025.100805

Abstract: Radiotherapy dose-response maps (DRM) combine dose-surface maps (DSM) and toxicity outcomes to identify high-risk subregions in organ-at-risk. This study assesses the impact of baseline toxicity correction on the identification of high-risk subregions in dose-response modeling for prostate cancer patients undergoing radiotherapy.The analysis included 1808 datasets, with 589 exclusions before toxicity-specific data removal. Bladder/rectum were automatically segmented on planning computed tomography scans, DSMs unwrapped into 91x90 voxel grids, and converted to equivalent doses in 2 Gy fractions (EQD2; α/β = 1 Gy). Seventeen late toxicities were assessed with two methods: (i) baseline toxicity subtracted from the maximum of 12- and 24-months toxicity scores, dichotomized at grade 1, and (ii) maximum of 12- and 24-months toxicity scores dichotomized at grade 1. DSMs were split accordingly, and voxel-wise t-values computed using Welch's t-equation. Statistically significant voxels were identified via the 95th percentile of maximum of t-value (Tmax) distribution.Event counts with baseline correction were 82/82/286/226 for urinary tract obstruction/retention/urgency/incontinence, respectively; without baseline correction, they were 93/104/465/361. For bladder DSMs, urinary incontinence, obstruction, retention, and urgency had 1143/186, 1768/1848, 516/0, and 33/0 significant voxels without/with baseline correction. For rectum DSMs, urinary incontinence and tract obstruction had 604/0 and 1980/889 significant voxels without/with baseline correction. However, no significant associations between rectal DSMs and rectum-related toxicities were found.DRM without baseline correction appears more sensitive to high-risk subregions due to higher event counts. Non-linear toxicity grading and multivariable analysis may enhance DRM reliability.

Keyword(s): Dose-toxicity modeling ; IBDM ; Organ-at-risk ; Prostate cancer ; Radiotherapy ; VBA

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Contributing Institute(s):

1. Epidemiologie von Krebs (C020)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2025

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Database coverage:
; ; Article Processing Charges ; Clarivate Analytics Master Journal List ; DOAJ Seal ; Emerging Sources Citation Index ; Fees ; SCOPUS ; Web of Science Core Collection

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