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Title: Hypofractionated Accelerated Radiotherapy Using Concomitant Intensity-Modulated Radiotherapy Boost Technique for Localized High-Risk Prostate Cancer: Acute Toxicity Results

Abstract

Purpose: To evaluate the acute toxicities of hypofractionated accelerated radiotherapy (RT) using a concomitant intensity-modulated RT boost in conjunction with elective pelvic nodal irradiation for high-risk prostate cancer. Methods and Materials: This report focused on 66 patients entered into this prospective Phase I study. The eligible patients had clinically localized prostate cancer with at least one of the following high-risk features (Stage T3, Gleason score {>=}8, or prostate-specific antigen level >20 ng/mL). Patients were treated with 45 Gy in 25 fractions to the pelvic lymph nodes using a conventional four-field technique. A concomitant intensity-modulated radiotherapy boost of 22.5 Gy in 25 fractions was delivered to the prostate. Thus, the prostate received 67.5 Gy in 25 fractions within 5 weeks. Next, the patients underwent 3 years of adjuvant androgen ablative therapy. Acute toxicities were assessed using the Common Terminology Criteria for Adverse Events, version 3.0, weekly during treatment and at 3 months after RT. Results: The median patient age was 71 years. The median pretreatment prostate-specific antigen level and Gleason score was 18.7 ng/L and 8, respectively. Grade 1-2 genitourinary and gastrointestinal toxicities were common during RT but most had settled at 3 months after treatment. Only 5 patients had acutemore » Grade 3 genitourinary toxicity, in the form of urinary incontinence (n = 1), urinary frequency/urgency (n = 3), and urinary retention (n = 1). None of the patients developed Grade 3 or greater gastrointestinal or Grade 4 or greater genitourinary toxicity. Conclusion: The results of the present study have indicated that hypofractionated accelerated RT with a concomitant intensity-modulated RT boost and pelvic nodal irradiation is feasible with acceptable acute toxicity.« less

Authors:
 [1];  [2];  [1];  [3]; ;  [1];  [2];  [4];  [2]; ;  [1];  [2]; ;  [1]; ;  [1];  [2];  [5];  [1];  [2]
  1. Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON (Canada)
  2. (Canada)
  3. (Canada), E-mail: patrick.cheung@sunnybrook.ca
  4. Department of Radiation Oncology, University of Toronto, Toronto, ON (Canada)
  5. Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States)
Publication Date:
OSTI Identifier:
21124427
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 72; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2007.12.041; PII: S0360-3016(08)00035-7; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANDROGENS; ANTIGENS; CARCINOMAS; IRRADIATION; LYMPH NODES; PATIENTS; PROSTATE; RADIOTHERAPY; TOXICITY

Citation Formats

Lim, Tee S., Department of Radiation Oncology, University of Toronto, Toronto, ON, Cheung, Patrick, Department of Radiation Oncology, University of Toronto, Toronto, ON, Loblaw, D. Andrew, Morton, Gerard, Department of Radiation Oncology, University of Toronto, Toronto, ON, Sixel, Katharina E., R. S. McLaughlin Durham Regional Cancer Centre, Oshawa, Pang, Geordi, Basran, Parminder, Department of Radiation Oncology, University of Toronto, Toronto, ON, Zhang Liying, Tirona, Romeo, Szumacher, Ewa, Danjoux, Cyril, Department of Radiation Oncology, University of Toronto, Toronto, ON, Choo, Richard, Thomas, Gillian, and Department of Radiation Oncology, University of Toronto, Toronto, ON. Hypofractionated Accelerated Radiotherapy Using Concomitant Intensity-Modulated Radiotherapy Boost Technique for Localized High-Risk Prostate Cancer: Acute Toxicity Results. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2007.12.041.
Lim, Tee S., Department of Radiation Oncology, University of Toronto, Toronto, ON, Cheung, Patrick, Department of Radiation Oncology, University of Toronto, Toronto, ON, Loblaw, D. Andrew, Morton, Gerard, Department of Radiation Oncology, University of Toronto, Toronto, ON, Sixel, Katharina E., R. S. McLaughlin Durham Regional Cancer Centre, Oshawa, Pang, Geordi, Basran, Parminder, Department of Radiation Oncology, University of Toronto, Toronto, ON, Zhang Liying, Tirona, Romeo, Szumacher, Ewa, Danjoux, Cyril, Department of Radiation Oncology, University of Toronto, Toronto, ON, Choo, Richard, Thomas, Gillian, & Department of Radiation Oncology, University of Toronto, Toronto, ON. Hypofractionated Accelerated Radiotherapy Using Concomitant Intensity-Modulated Radiotherapy Boost Technique for Localized High-Risk Prostate Cancer: Acute Toxicity Results. United States. doi:10.1016/j.ijrobp.2007.12.041.
Lim, Tee S., Department of Radiation Oncology, University of Toronto, Toronto, ON, Cheung, Patrick, Department of Radiation Oncology, University of Toronto, Toronto, ON, Loblaw, D. Andrew, Morton, Gerard, Department of Radiation Oncology, University of Toronto, Toronto, ON, Sixel, Katharina E., R. S. McLaughlin Durham Regional Cancer Centre, Oshawa, Pang, Geordi, Basran, Parminder, Department of Radiation Oncology, University of Toronto, Toronto, ON, Zhang Liying, Tirona, Romeo, Szumacher, Ewa, Danjoux, Cyril, Department of Radiation Oncology, University of Toronto, Toronto, ON, Choo, Richard, Thomas, Gillian, and Department of Radiation Oncology, University of Toronto, Toronto, ON. Mon . "Hypofractionated Accelerated Radiotherapy Using Concomitant Intensity-Modulated Radiotherapy Boost Technique for Localized High-Risk Prostate Cancer: Acute Toxicity Results". United States. doi:10.1016/j.ijrobp.2007.12.041.
@article{osti_21124427,
title = {Hypofractionated Accelerated Radiotherapy Using Concomitant Intensity-Modulated Radiotherapy Boost Technique for Localized High-Risk Prostate Cancer: Acute Toxicity Results},
author = {Lim, Tee S. and Department of Radiation Oncology, University of Toronto, Toronto, ON and Cheung, Patrick and Department of Radiation Oncology, University of Toronto, Toronto, ON and Loblaw, D. Andrew and Morton, Gerard and Department of Radiation Oncology, University of Toronto, Toronto, ON and Sixel, Katharina E. and R. S. McLaughlin Durham Regional Cancer Centre, Oshawa and Pang, Geordi and Basran, Parminder and Department of Radiation Oncology, University of Toronto, Toronto, ON and Zhang Liying and Tirona, Romeo and Szumacher, Ewa and Danjoux, Cyril and Department of Radiation Oncology, University of Toronto, Toronto, ON and Choo, Richard and Thomas, Gillian and Department of Radiation Oncology, University of Toronto, Toronto, ON},
abstractNote = {Purpose: To evaluate the acute toxicities of hypofractionated accelerated radiotherapy (RT) using a concomitant intensity-modulated RT boost in conjunction with elective pelvic nodal irradiation for high-risk prostate cancer. Methods and Materials: This report focused on 66 patients entered into this prospective Phase I study. The eligible patients had clinically localized prostate cancer with at least one of the following high-risk features (Stage T3, Gleason score {>=}8, or prostate-specific antigen level >20 ng/mL). Patients were treated with 45 Gy in 25 fractions to the pelvic lymph nodes using a conventional four-field technique. A concomitant intensity-modulated radiotherapy boost of 22.5 Gy in 25 fractions was delivered to the prostate. Thus, the prostate received 67.5 Gy in 25 fractions within 5 weeks. Next, the patients underwent 3 years of adjuvant androgen ablative therapy. Acute toxicities were assessed using the Common Terminology Criteria for Adverse Events, version 3.0, weekly during treatment and at 3 months after RT. Results: The median patient age was 71 years. The median pretreatment prostate-specific antigen level and Gleason score was 18.7 ng/L and 8, respectively. Grade 1-2 genitourinary and gastrointestinal toxicities were common during RT but most had settled at 3 months after treatment. Only 5 patients had acute Grade 3 genitourinary toxicity, in the form of urinary incontinence (n = 1), urinary frequency/urgency (n = 3), and urinary retention (n = 1). None of the patients developed Grade 3 or greater gastrointestinal or Grade 4 or greater genitourinary toxicity. Conclusion: The results of the present study have indicated that hypofractionated accelerated RT with a concomitant intensity-modulated RT boost and pelvic nodal irradiation is feasible with acceptable acute toxicity.},
doi = {10.1016/j.ijrobp.2007.12.041},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 72,
place = {United States},
year = {2008},
month = {9}
}