Local protocol variations for Image-Guided Radiotherapy in the multicenter Dutch hypofractionation (HYPRO) trial: impact of rectal balloon and MRI delineation on anorectal dose and gastrointestinal toxicity levels

The effects of differences in techniques and treatment protocols on patient-reported rectal toxicity were compared between treatment centers participating in the prospective prostate XXX trial. All included centers applied image-guided-IMRT using identical anorectal dose constraints. As compared to reference center A (5-6mm PTV margins), favorable anorectal dose distributions were found for center B (MRI delineation, 7mm margins) and center C (endorectal balloon application, 7mm margins). This translated into significantly lower incidences of rectal complaints within both centers.

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