{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:36:25Z","timestamp":1787027785848,"version":"build-2736575974"},"reference-count":44,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Although prostate cancer treatment is increasingly effective, its toxicities pose a major concern. The aim of our study was to assess the rate of adverse events (AEs) and the prognostic value of dose\u2013volume histogram (DVH) parameters for the occurrence of treatment toxicity in patients treated with post-prostatectomy prostate bed radiotherapy (RT). The AEs were scored according to the CTCAE v.5.0. The rectum and bladder were contoured according to the RTOG Guidelines. The DVH parameters were assessed using data exported from the ECLIPSE treatment-planning system. Genitourinary (GU) and gastrointestinal (GI) toxicity were analysed using consecutive dose thresholds for the percentage of an organ at risk (OAR) receiving a given dose and the QUANTEC dose constraints. A total of 213 patients were included in the final analysis. Acute grade 2 or higher (\u2265G2) GU AEs occurred in 18.7% and late in 21.3% of patients. Acute \u2265G2 GI toxicity occurred in 11.7% and late \u2265G2 in 11.2% of the patients. Five patients experienced grade 4 AEs. The most common adverse effects were diarrhoea, proctitis, cystitis, and dysuria. The most significant predictors of acute \u2265G2 GI toxicity were rectum V47 and V46 (p &lt; 0.001 and p &lt; 0.001) and rectum wall V46 (p = 0.001), whereas the most significant predictors of late \u2265G2 GI AEs were rectum wall V47 and V48 (p = 0.019 and p = 0.021). None of the bladder or bladder wall parameters was significantly associated with the risk of acute toxicity. The minimum doses to bladder wall (p = 0.004) and bladder (p = 0.005) were the most significant predictors of late \u2265G2 GU toxicity. Postoperative radiotherapy is associated with a clinically relevant risk of AEs, which is associated with DVH parameters, and remains even in patients who fulfil commonly accepted dose constraints. Considering the lack of survival benefit of postoperative adjuvant RT, our results support delaying treatment through an early salvage approach to avoid or defer toxicity.<\/jats:p>","DOI":"10.3390\/cancers15225334","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T03:42:40Z","timestamp":1699501360000},"page":"5334","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Rectum and Bladder Toxicity in Postoperative Prostate Bed Irradiation: Dose\u2013Volume Parameters Analysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Maja","family":"Hasterok","sequence":"first","affiliation":[{"name":"IIIrd Radiotherapy and Chemotherapy Department, Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Wybrze\u017ce Armii Krajowej 15, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Szo\u0142tysik","sequence":"additional","affiliation":[{"name":"IIIrd Radiotherapy and Chemotherapy Department, Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Wybrze\u017ce Armii Krajowej 15, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuzanna","family":"Nowicka","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Translational Medicine, Medical University of Lodz, Mazowiecka 15, 92-215 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart\u0142omiej","family":"Goc","sequence":"additional","affiliation":[{"name":"Radiotherapy Department, Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Wybrze\u017ce Armii Krajowej 15, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donata","family":"Gr\u00e4upner","sequence":"additional","affiliation":[{"name":"IIIrd Radiotherapy and Chemotherapy Department, Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Wybrze\u017ce Armii Krajowej 15, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Majewski","sequence":"additional","affiliation":[{"name":"Radiotherapy Department, Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Wybrze\u017ce Armii Krajowej 15, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Ras\u0142awski","sequence":"additional","affiliation":[{"name":"Radiotherapy Department, Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Wybrze\u017ce Armii Krajowej 15, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"Rajwa","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Vienna, W\u00e4hringer G\u00fcrtel 18-20, 1090 Vienna, Austria"},{"name":"Department of Urology, Medical University of Silesia, 3-go Maja 13-15, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iwona","family":"Jab\u0142o\u0144ska","sequence":"additional","affiliation":[{"name":"IIIrd Radiotherapy and Chemotherapy Department, Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Wybrze\u017ce Armii Krajowej 15, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0141ukasz","family":"Magrowski","sequence":"additional","affiliation":[{"name":"IIIrd Radiotherapy and Chemotherapy Department, Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Wybrze\u017ce Armii Krajowej 15, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7381-7420","authenticated-orcid":false,"given":"Miko\u0142aj","family":"Przydacz","sequence":"additional","affiliation":[{"name":"Department of Urology, Jagiellonian University Medical College, Macieja Jakubowskiego 2, 30-688 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Krajewski","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive and Robotic Urology, Wroc\u0142aw Medical University, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliwia","family":"Masri","sequence":"additional","affiliation":[{"name":"IIIrd Radiotherapy and Chemotherapy Department, Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Wybrze\u017ce Armii Krajowej 15, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4375-0827","authenticated-orcid":false,"given":"Marcin","family":"Miszczyk","sequence":"additional","affiliation":[{"name":"IIIrd Radiotherapy and Chemotherapy Department, Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Wybrze\u017ce Armii Krajowej 15, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1016\/S1470-2045(20)30456-3","article-title":"Adjuvant Radiotherapy versus Early Salvage Radiotherapy Following Radical Prostatectomy (TROG 08.03\/ANZUP RAVES): A Randomised, Controlled, Phase 3, Non-Inferiority Trial","volume":"21","author":"Kneebone","year":"2020","journal-title":"Lancet 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