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Int J Radiat Oncol Biol Phys. 2011 Jun 1;80(2):608-13. doi: 10.1016/j.ijrobp.2010.07.1994. Epub 2010 Oct 8.

A method for the prediction of late organ-at-risk toxicity after radiotherapy of the prostate using equivalent uniform dose.

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Clinical Trials Unit, St. Luke's Hospital, Rathgar, Dublin, Ireland.



To evaluate the predictive value of equivalent uniform doses (EUD) for late bladder and rectal toxicity after high-dose three-dimensional conformal radiation therapy (3D-CRT) to the prostate.


Using the method developed by Kutcher et al., EUDs for whole bladder and rectum were calculated from the dose-volume histograms of 180 patients with localized prostate cancer treated to 70-74 Gy with 3D-CRT. Late complications were recorded using the Radiation Therapy Oncology Group scale, correlated against EUD and known physical predictive indicators.


EUD is an independent prognostic factor for Grade 2+ long-term rectal and bladder toxicity after radiation treatment to the prostate. Patients receiving an EUD >63.1 Gy to the rectum have a statistically significant (10% vs. 30%; p = 0.002) higher risk of developing Grade 2+ late complications. Patients receiving an EUD >53.4 Gy to the bladder have a statistically significant (10% vs. 33%; p = 0.001) higher risk of developing Grade 2+ late complications.


It has been demonstrated that EUD is a strong independent predictive factor for Grade 2+ late complications after 3D-CRT to the prostate. Threshold values have been demonstrated for both bladder and rectum, above which there is a clinically significant increased risk of complications.

[Indexed for MEDLINE]

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