Michael G. Chang

Lovastatin may reduce the risk of erectile dysfunction following radiation therapy for prostate cancer

reported. Yoshida et al. developed and validated the UBTAT-tool and correlated it to radiation-induced morbidity by RTOG score [3]. UBTAT measurements correlated with late toxicity grades. Skin and subcutaneous endpoints were pooled, and it is unknown if the UBTAT-tool can distinguish between these endpoints. Zhou et al. found two US measures from subcutaneous tissue in women treated with RT for early breast cancer being significantly different between irradiated and contralateral breast. Findings were not correlated to a clinical assessment of radiation-induced morbidity [5]. To our knowledge, our pilot study is the first to consider both induration and edema, but has a small sample size and an inadequate protocol for data acquisition of density measures in edematous patients. We found the largest difference in dermis thickness of 1.61 mm in patients with grade 2 induration combined with edema, whereas the lowest of 0.35 mm was for patients with grade 1 induration and without edema, although the latter was not statistically significant. Regression analysis showed a significant effect of edema, increasing dermis thickness with a mean 1.01 mm when present versus not present. The effect of induration alone remains inconclusive. Presently, we do not see US/HFUS evaluation of the skin as a part of large-scale follow-up routines in the assessment of radiation-induced morbidity. Data from the present study and the literature confirm a measurable skin (dermis ± epidermis) thickness difference present between irradiated and nonirradiated breast after RT, which is partly caused by edema. What we still seek is a reliable discriminative quality between radiation-induced morbidity endpoints and their grades. This would enable inter-individual and -institutional quality assurance and serve as an objective marker in future trials testing new regimens in treatment of radiation-induced morbidity of the skin.

Phase I/II study of hypofractionated intensity modulated radiotherapy (IMRT) for prostate cancer including simultaneously integrated boost (SIB).

67 Background: The purpose of this study is to evaluate the toxicity of hypofractionationed H- IMRT treatment including SIB IMRT when pelvic nodes were covered. Additionally, we assessed early treatment efficacy through PSA control (biochemical failure defined as PSA more than nadir + 2 ng/mL). Methods: Men with localized prostate cancer were enrolled in a phase I/II trial to receive H-IMRT to the prostate, seminal vesicles)(SV) and pelvic lymph nodes (LN) using simultaneous integrated boost (SIB) method. Low risk (LR) patients received 69.4 Gy to the prostate only in 29 fractions. The intermediate (IR) and high risk (HR) patients received 72 Gy to the prostate, 54 Gy to the proximal 1 cm SV, and 50.4 Gy to the pelvic LN when risk of LN involvement >15% by Roach formula. Treatment was given in 30 fractions using intraprostatic fiducials and daily image guidance. PTV expansion for prostate and SV was 0.3 mm posteriorly and 0.7 cm in all other directions. The IR and HR patients received androgen deprivation...