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KMID : 1038620130310040199
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Radiation Oncology Journal
2013 Volume.31 No. 4 p.199 ~ p.205
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Whole pelvic intensity-modulated radiotherapy for high-risk prostate cancer: a preliminary report
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Joo Ji-Hyeon
Kim Yeon-Joo
Kim Young-Seok
Choi Eun-Kyung
Kim Jong-Hoon
Lee Sang-Wook
Song Si-Yeol
Yoon Sang-Min
Kim Su-Ssan
Park Ji-Hong
Jeong Yu-Ri
Ahn Han-Jong
Kim Choung-Soo
Lee Jae-Lyun
Ahn Seung-Do
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Abstract
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Purpose: To assess the clinical efficacy and toxicity of whole pelvic intensity-modulated radiotherapy (WP-IMRT) for high-risk prostate cancer.
Materials and Methods:Patients with high-risk prostate cancer treated between 2008 and 2013 were reviewed. The study included patients who had undergone WP-IMRT with image guidance using electronic portal imaging devices and/or cone-beam computed tomography. The endorectal balloon was used in 93% of patients. Patients received either 46 Gy to the whole pelvis plus a boost of up to 76 Gy to the prostate in 2 Gy daily fractions, or 44 Gy to the whole pelvis plus a boost of up to 72.6 Gy to the prostate in 2.2 Gy fractions.
Results: The study cohort included 70 patients, of whom 55 (78%) had a Gleason score of 8 to 10 and 50 (71%) had a prostate-specific antigen level > 20 ng/mL. The androgen deprivation therapy was combined in 62 patients. The biochemical failure-free survival rate was 86.7% at 2 years. Acute any grade gastrointestinal (GI) and genitourinary (GU) toxicity rates were 47% and 73%, respectively. The actuarial rate of late grade 2 or worse toxicity at 2 years was 12.9% for GI, and 5.7% for GU with no late grade 4 toxicity.
Conclusion: WP-IMRT was well tolerated with no severe acute or late toxicities, resulting in at least similar biochemical control to that of the historic control group with a small field. The long-term efficacy and toxicity will be assessed in the future, and a prospective randomized trial is needed to verify these findings.
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KEYWORD
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Prostate neoplasms, Intensity-modulated radiotherapy, Complications
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