scholarly journals (P039) Updated Acute and Late Gastrointestinal and Genitourinary Toxicity of Dose-Escalated Image-Guided Intensity Modulated Radiation Therapy for Prostate Cancer Using a Daily Water-Filled Endorectal Balloon

2017 ◽  
Vol 98 (2) ◽  
pp. E25-E26
Author(s):  
Christopher Montoya ◽  
Neha Vapiwala ◽  
Stefan Both ◽  
Curtiland Deville
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Image Guided ◽  
Intensity Modulated ◽  
Genitourinary Toxicity ◽  
Endorectal Balloon ◽  
Daily Water

scholarly journals Randomized Trial of Hypofractionated, Dose-Escalated, Intensity-Modulated Radiation Therapy (IMRT) Versus Conventionally Fractionated IMRT for Localized Prostate Cancer

2018 ◽  
Vol 36 (29) ◽  
pp. 2943-2949 ◽  
Author(s):  
Karen E. Hoffman ◽  
K. Ranh Voong ◽  
Lawrence B. Levy ◽  
Pamela K. Allen ◽  
Seungtaek Choi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Randomized Trial ◽  
Intensity Modulated Radiation Therapy ◽  
Cancer Control ◽  
Localized Prostate Cancer ◽  
Intensity Modulated ◽  
Genitourinary Toxicity ◽  
Gi Toxicity ◽  
Conventionally Fractionated

Purpose Hypofractionated radiotherapy delivers larger daily doses of radiation and may increase the biologically effective dose delivered to the prostate. We conducted a randomized trial testing the hypothesis that dose-escalated, moderately hypofractionated intensity-modulated radiation therapy (HIMRT) improves prostate cancer control compared with conventionally fractionated IMRT (CIMRT) for men with localized prostate cancer. Patients and Methods Men were randomly assigned to 75.6 Gy in 1.8-Gy fractions delivered over 8.4 weeks (CIMRT) or 72 Gy in 2.4 Gy fractions delivered over 6 weeks (HIMRT, biologically equivalent to 85 Gy in 1.8-Gy fractions assuming prostate cancer α-to-β ratio of 1.5). Failure was defined as prostate-specific antigen (PSA) failure (nadir plus 2 ng/mL) or initiation of salvage therapy. Modified Radiation Therapy Oncology Group criteria were used to grade late (≥ 90 days after completion of radiotherapy) GI and genitourinary toxicity. Results Most of the 206 men (72%) had cT1, Gleason score 6 or 7 (99%), and PSA level ≤ 10 ng/mL (90%) disease. Androgen deprivation therapy was received by 24%. With a median follow-up of 8.5 years, men treated with HIMRT experienced fewer treatment failures (n = 10) than men treated with CIMRT (n = 21; P = .036). The 8-year failure rate was 10.7% (95% CI, 5.8% to 19.1%) with HIMRT and 15.4% (95% CI, 9.1% to 25.4%) with CIMRT. There was no difference in overall survival ( P = .39). There was a nonsignificant increase in late grade 2 or 3 GI toxicity with HIMRT (8-year 5.0% v 12.6%; P = .08). However, GI toxicity was only 8.6% when rectal volume receiving 65 Gy of HIMRT was ≤ 15%. Late genitourinary toxicity was similar ( P = .84). There was no grade 4 toxicity. Conclusion The results of this randomized trial demonstrate superior cancer control for men with localized prostate cancer who receive dose-escalated moderately hypofractionation radiotherapy while shortening treatment duration.

Sign in / Sign up

Export Citation Format

Share Document