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Intensity-Modulated Radiation Therapy with Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on 3-Year Toxicity.

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Τίτλος: Intensity-Modulated Radiation Therapy with Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on 3-Year Toxicity.
Συγγραφείς: Paydar I; Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA., Pepin A; George Washington University , Washington, DC , USA., Cyr RA; Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA., King J; University of South Carolina School of Medicine , Columbia, SC , USA., Yung TM; Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA., Bullock EG; Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA., Lei S; Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA., Satinsky A; Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA., Harter KW; Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA., Suy S; Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA., Dritschilo A; Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA., Lynch JH; Department of Urology, Georgetown University Hospital , Washington, DC , USA., Kole TP; Department of Radiation Oncology, The Valley Hospital , Ridgewood, NJ , USA., Collins SP; Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA.
Πηγή: Frontiers in oncology [Front Oncol] 2017 Feb 07; Vol. 7, pp. 5. Date of Electronic Publication: 2017 Feb 07 (Print Publication: 2017).
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Frontiers Research Foundation] Country of Publication: Switzerland NLM ID: 101568867 Publication Model: eCollection Cited Medium: Print ISSN: 2234-943X (Print) Linking ISSN: 2234943X NLM ISO Abbreviation: Front Oncol Subsets: PubMed not MEDLINE
Imprint Name(s): Original Publication: [Lausanne : Frontiers Research Foundation]
Περίληψη: Background: Recent data suggest that intensity-modulated radiation therapy (IMRT) plus brachytherapy boost for unfavorable prostate cancer provides improved biochemical relapse-free survival over IMRT alone. Stereotactic body radiation therapy (SBRT) may be a less invasive alternative to brachytherapy boost. Here, we report the 3-year gastrointestinal (GI) and genitourinary (GU) toxicities of IMRT plus SBRT boost.
Materials and Methods: Between March 2008 and September 2012, patients with prostate cancer were treated with robotic SBRT (19.5 Gy in three fractions) followed by fiducial-guided IMRT (45-50.4 Gy) on an institutional protocol. Toxicity was prospectively graded using the common terminology criteria for adverse events version 4.0 (CTCAEv.4) at the start of and at 1- to 6-month intervals after therapy. Rectal telangiectasias were graded using the Vienna Rectoscopy Score (VRS).
Results: At a median follow-up of 4.2 years (2.4-7.5), 108 patients (4 low-, 45 intermediate-, and 59 high-risk) with a median age of 74 years (55-92) were treated with SBRT plus IMRT, with 8% on anticoagulation and an additional 48% on antiplatelet therapy at the start of therapy. The cumulative incidence of late ≥grade 2 GI toxicity was 12%. Of these, 7% were due to late rectal bleeding, with six patients requiring up to two coagulation procedures. One patient with rectal telangiectasias was treated with hyperbaric oxygen (grade 3 toxicity). No rectal fistulas or stenoses were observed. Ten patients had multiple non-confluent telangiectasias (VRS grade 2), and three patients had multiple confluent telangiectasias (VRS grade 3). The cumulative incidence of late grade 3 GU toxicity was 6%. Most late toxicities were due to hematuria requiring bladder fulguration. There were no late ≥grade 4 GU toxicities.
Conclusion: Rates of clinically significant GI and GU toxicities are modest following IMRT plus SBRT boost. Future studies should compare cancer control, quality of life, and toxicity with other treatment modalities for patients with high-risk prostate cancer.
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Grant Information: P30 CA051008 United States CA NCI NIH HHS
Contributed Indexing: Keywords: CyberKnife; IMRT; SBRT; common terminology criteria; prostate cancer
Entry Date(s): Date Created: 20170223 Latest Revision: 20220408
Update Code: 20260130
PubMed Central ID: PMC5293802
DOI: 10.3389/fonc.2017.00005
PMID: 28224113
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:2234-943X
DOI:10.3389/fonc.2017.00005