From the Research
Grade 1,2, and 3 Toxicities Associated with Whole Pelvic Radiation Therapy (WPRT)
- Grade 1 toxicities are generally mild and may not require medication, while Grade 2 and 3 toxicities are more severe and may require medical intervention 1, 2, 3, 4, 5.
- The frequencies of Grade 1,2, and 3 toxicities associated with WPRT vary across studies, but generally, Grade 1 toxicities are more common than Grade 2 and 3 toxicities 2, 3, 4, 5.
- In one study, the percentages of patients with Grade 1,2, and 3 gastrointestinal toxicities after WPRT were 8.3%, 2.8%, and 0%, respectively 2.
- Another study reported that during Week 5 of WPRT, acute Grade 1-3 GI morbidities were observed in 19 (12.2%), 2 (1.3%), and 1 (0.6%) patients, respectively, and genitourinary toxicity was similar, accounting for 17 (10.9%), 6 (3.8%), and 1 (0.6%) patients, respectively 3.
- A comparative study found that WPRT was associated with a significantly higher rate of acute grade 2 gastrointestinal toxic effects (29.4% vs 14.7%, P = .008) and late grade 2 urinary adverse effects (45.6% vs 25.0%, P = .003) compared to prostate-only radiation therapy 4.
- However, another study found that WPRT did not increase late gastrointestinal and genitourinary toxicities compared to prostate-only radiation therapy, with frequencies of Grade 3 late GI and GU toxicities ≤3% across both groups 5.
Factors Influencing Toxicity
- Age and comorbidity may be associated with increased toxicity, with older patients and those with comorbidities experiencing more gastrointestinal toxicity 2, 3.
- The use of intensity-modulated radiation therapy (IMRT) may reduce toxicity compared to conventional radiation therapy, with one study finding that IMRT was associated with significantly fewer grade ≥2 acute gastrointestinal toxicities and grade ≥3 gastrointestinal toxicities 1.
- Diet restriction and psychosocial input may also have a positive impact on reducing toxicity 3.