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.
Written by:
Joo JH, Kim YJ, Kim YS, Choi EK, Kim JH, Lee SW, Song SY, Yoon SM, Kim SS, Park JH, Jeong Y, Ahn H, Kim CS, Lee JL, Ahn SD. Are you the author?
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Reference: Radiat Oncol J. 2013 Dec;31(4):199-205.
doi: 10.3857/roj.2013.31.4.199
PubMed Abstract
PMID: 24501707
UroToday.com Prostate Cancer Section
