Commentary on “Secondary cancers after intensity-modulated radiotherapy, brachytherapy, and radical prostatectomy for the treatment of prostate cancer: Incidence and cause-specific survival outcomes according to the initial treatment intervention.” Zelefsky MJ, Pei X, Teslova T, Kuk D, Magsanoc JM, Kollmeier M, Cox B, Zhang Z. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY.

2014 ◽  
Vol 32 (2) ◽  
pp. 209
Author(s):  
Alexander Gottschalk
Keyword(s):  
Prostate Cancer ◽  
New York ◽  
Radiation Oncology ◽  
Intensity Modulated Radiotherapy ◽  
Cancer Center ◽  
Survival Outcomes ◽  
Treatment Intervention ◽  
Prostate Cancer Incidence ◽  
Intensity Modulated ◽  
Cause Specific Survival

scholarly journals Outcome and patient-reported toxicity in localised prostate cancer treated with dose-escalated hypofractionated intensity-modulated radiotherapy

2013 ◽  
Vol 12 (4) ◽  
pp. 326-333
Author(s):  
David Thomson ◽  
Sophie Merrick ◽  
Ric Swindell ◽  
James Wylie ◽  
Richard Cowan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
High Risk ◽  
Intensity Modulated Radiotherapy ◽  
Late Toxicity ◽  
Phase Iii ◽  
Patient Questionnaire ◽  
Intensity Modulated ◽  
High Risk Disease ◽  
Cause Specific Survival

AbstractObjectiveTo report outcomes and late toxicity for a hypofractionated dose-escalated radiotherapy schedule in patients treated using intensity-modulated radiotherapy (IMRT) for localised prostate cancer.Materials and methodsEighty-eight men with localised prostate cancer were treated with 57 Gy in 19 daily fractions over 4 weeks. A total of 70 out of 88 had high-risk disease. Overall survival, cause-specific survival and biochemical progression-free survival (bPFS, Phoenix definition) were reported. Toxicity was measured retrospectively using Radiation Therapy Oncology Group (RTOG) criteria and assessed prospectively with a validated Late Effects in Normal Tissues Subjective, Objective, Management and Analytic (LENT/SOMA) patient questionnaire.ResultsAt 5 years, overall survival was 84%, cause-specific survival 88% and bPFS 65%. In patients with high-risk disease, 5-year bPFS was 62%. There was no RTOG toxicity above grade III. LENT/SOMA questionnaires were returned by 74% patients. Median scores for bowel and urinary function were <1. Maximum bowel and urinary toxicity scores ≥2 were reported by 64% and 59% of patients, respectively. The median score for sexual function was 1·5, but nearly all (96%) patients recorded a toxicity score ≥2 for at least one question.ConclusionsDose-escalated hypofractionated radiotherapy delivered using IMRT has promising outcomes and acceptable late toxicity. This fractionation schedule is being compared with conventional treatment within an on-going multicentre phase III clinical trial.

Acute patient-reported toxicities after proton therapy or intensity-modulated radiotherapy for prostate cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 305-305
Author(s):  
Kimberly Gergelis ◽  
Miao Bai ◽  
Thomas Whitaker ◽  
David M. Routman ◽  
Mustafa Sir ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Stage ◽  
Intensity Modulated Radiotherapy ◽  
Bowel Function ◽  
Proton Beam Therapy ◽  
Cancer Center ◽  
Significant Deterioration ◽  
Intensity Modulated ◽  
Patient Reported ◽  
Acute Patient

305 Background: Toxicity due to radiotherapy (RT) may differ in patients (pts) with prostate cancer who receive intensity-modulated radiotherapy (IMRT) or proton beam therapy (PBT). Methods: Patient-reported bowel function (BF), urinary incontinence (UI), and urinary irritative/obstructive symptoms (UO) domains of the Expanded Prostate Index Composite Questionnaire (EPIC-26) were prospectively collected in pts with localized prostate cancer receiving either IMRT (n=157) or PBT (n=105) to the prostate +/- proximal seminal vesicles for clinical stage T1-T2 N0 prostate cancer at a single tertiary cancer center between 2015 and 2018. Changes in domain scores were analyzed from pretreatment to the end of RT and 3 months post-RT, assessing the acute effects of each modality. A clinically relevant change was defined as a score change that exceeded 50% of the standard deviation of a baseline value. Results: At baseline there was no difference in the scores of BF, UI, and UO domains between IMRT and PBT cohorts. At the end of RT, pts treated with either modality had a statistically significant and clinically relevant worsening of BF and UO compared to baseline. Pts treated with IMRT experienced a significantly greater decrement in BF compared to the PBT cohort (-13 vs -9, p<0.01), including significantly more IMRT pts having a clinically relevant deterioration in BF compared to PBT pts (58% vs 40%, p=0.01). Though there was a statistically significant deterioration in UI in the IMRT cohort (-4, p<0.001), this did not reach the predefined threshold for clinical relevance. Three months following RT, the IMRT group continued to have statistically significant and clinically relevant worsening of BF (-9, p<0.001), whereas the change in BF domain score of the PBT cohort was no longer statistically significant or clinically relevant compared to baseline (-1, p=0.25). There were no statistically significant or clinically relevant changes in UO or UI in either cohort at three months when compared to baseline. Conclusions: Pts who received IMRT or PBT reported unique patterns of toxicity, and pts treated with IMRT had worse decrement in BF immediately after and three months following RT, compared to those treated with PBT.

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