skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Hypofractionated Boost to the Dominant Tumor Region With Intensity Modulated Stereotactic Radiotherapy for Prostate Cancer: A Sequential Dose Escalation Pilot Study

Abstract

Purpose: To evaluate the feasibility, tolerability, and preliminary outcomes in patients with prostate cancer treated according to a hypofractionated dose escalation protocol to boost the dominant tumor-bearing region of the prostate. Methods and Materials: After conventional fractionated external radiotherapy to 64 to 64.4Gy, 50 patients with nonmetastatic prostate cancer were treated with an intensity-modulated radiotherapy hypofractionated boost under stereotactic conditions to a reduced prostate volume to the dominant tumor region. A rectal balloon inflated with 60cc of air was used for internal organ immobilization. Five, 8, and 8 patients were sequentially treated with two fractions of 5, 6, or 7Gy, respectively (normalized total dose in 2Gy/fraction [NTD{sub 2Gy}] < 100Gy, low-dose group), whereas 29 patients received two fractions of 8Gy each (NTD{sub 2Gy} > 100Gy, high-dose group). Androgen deprivation was given to 33 patients. Acute and late toxicities were assessed according to the Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer (RTOG/EORTC) scoring system. Results: Two patients presented with Grade 3 acute urinary toxicity. The 5-year probabilities of {>=}Grade 2 late urinary and late low gastrointestinal (GI) toxicity-free survival were 82.2% {+-} 7.4% and 72.2% {+-} 7.6%, respectively. The incidence and severity of acute or late toxicitiesmore » were not correlated with low- vs. high-dose groups, pelvic irradiation, age, or treatment with or without androgen deprivation. The 5-year biochemical disease-free survival (b-DFS) and disease-specific survival were 98% {+-} 1.9% and 100%, respectively. Conclusion: Intensity-modulated radiotherapy hypofractionated boost dose escalation under stereotactic conditions was feasible, and showed excellent outcomes with acceptable long-term toxicity. This approach may well be considered an alternative to high-dose-rate brachytherapy.« less

Authors:
 [1];  [2];  [1];  [3];  [4]; ;  [1];  [5];  [3]; ; ;  [1]
  1. Servei de Radio-oncologia, Institut Oncologic Teknon, Barcelona (Spain)
  2. (Switzerland)
  3. Service de Radio-oncologie, Hopitaux Universitaires de Geneve, Geneva (Switzerland)
  4. Servei de Radiodiagnostic, Centro Medico Teknon, Barcelona (Spain)
  5. Statistics Department, Barcelona Centre for International Health Research (CRESIB), Barcelona (Spain)
Publication Date:
OSTI Identifier:
21436140
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 78; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2009.07.1689; PII: S0360-3016(09)02767-9; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; FRACTIONATED IRRADIATION; NEOPLASMS; PROSTATE; RADIATION DOSES; RADIOTHERAPY; TOXICITY; BODY; DISEASES; DOSES; GLANDS; IRRADIATION; MALE GENITALS; MEDICINE; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; THERAPY

Citation Formats

Miralbell, Raymond, E-mail: Raymond.Miralbell@hcuge.c, Service de Radio-oncologie, Hopitaux Universitaires de Geneve, Geneva, Molla, Meritxell, Rouzaud, Michel, Hidalgo, Alberto, Toscas, Jose Ignacio, Lozano, Joan, Sanz, Sergi B.Sc., Ares, Carmen, Jorcano, Sandra, Linero, Dolors, and Escude, Lluis. Hypofractionated Boost to the Dominant Tumor Region With Intensity Modulated Stereotactic Radiotherapy for Prostate Cancer: A Sequential Dose Escalation Pilot Study. United States: N. p., 2010. Web. doi:10.1016/j.ijrobp.2009.07.1689.
Miralbell, Raymond, E-mail: Raymond.Miralbell@hcuge.c, Service de Radio-oncologie, Hopitaux Universitaires de Geneve, Geneva, Molla, Meritxell, Rouzaud, Michel, Hidalgo, Alberto, Toscas, Jose Ignacio, Lozano, Joan, Sanz, Sergi B.Sc., Ares, Carmen, Jorcano, Sandra, Linero, Dolors, & Escude, Lluis. Hypofractionated Boost to the Dominant Tumor Region With Intensity Modulated Stereotactic Radiotherapy for Prostate Cancer: A Sequential Dose Escalation Pilot Study. United States. doi:10.1016/j.ijrobp.2009.07.1689.
Miralbell, Raymond, E-mail: Raymond.Miralbell@hcuge.c, Service de Radio-oncologie, Hopitaux Universitaires de Geneve, Geneva, Molla, Meritxell, Rouzaud, Michel, Hidalgo, Alberto, Toscas, Jose Ignacio, Lozano, Joan, Sanz, Sergi B.Sc., Ares, Carmen, Jorcano, Sandra, Linero, Dolors, and Escude, Lluis. Wed . "Hypofractionated Boost to the Dominant Tumor Region With Intensity Modulated Stereotactic Radiotherapy for Prostate Cancer: A Sequential Dose Escalation Pilot Study". United States. doi:10.1016/j.ijrobp.2009.07.1689.
@article{osti_21436140,
title = {Hypofractionated Boost to the Dominant Tumor Region With Intensity Modulated Stereotactic Radiotherapy for Prostate Cancer: A Sequential Dose Escalation Pilot Study},
author = {Miralbell, Raymond, E-mail: Raymond.Miralbell@hcuge.c and Service de Radio-oncologie, Hopitaux Universitaires de Geneve, Geneva and Molla, Meritxell and Rouzaud, Michel and Hidalgo, Alberto and Toscas, Jose Ignacio and Lozano, Joan and Sanz, Sergi B.Sc. and Ares, Carmen and Jorcano, Sandra and Linero, Dolors and Escude, Lluis},
abstractNote = {Purpose: To evaluate the feasibility, tolerability, and preliminary outcomes in patients with prostate cancer treated according to a hypofractionated dose escalation protocol to boost the dominant tumor-bearing region of the prostate. Methods and Materials: After conventional fractionated external radiotherapy to 64 to 64.4Gy, 50 patients with nonmetastatic prostate cancer were treated with an intensity-modulated radiotherapy hypofractionated boost under stereotactic conditions to a reduced prostate volume to the dominant tumor region. A rectal balloon inflated with 60cc of air was used for internal organ immobilization. Five, 8, and 8 patients were sequentially treated with two fractions of 5, 6, or 7Gy, respectively (normalized total dose in 2Gy/fraction [NTD{sub 2Gy}] < 100Gy, low-dose group), whereas 29 patients received two fractions of 8Gy each (NTD{sub 2Gy} > 100Gy, high-dose group). Androgen deprivation was given to 33 patients. Acute and late toxicities were assessed according to the Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer (RTOG/EORTC) scoring system. Results: Two patients presented with Grade 3 acute urinary toxicity. The 5-year probabilities of {>=}Grade 2 late urinary and late low gastrointestinal (GI) toxicity-free survival were 82.2% {+-} 7.4% and 72.2% {+-} 7.6%, respectively. The incidence and severity of acute or late toxicities were not correlated with low- vs. high-dose groups, pelvic irradiation, age, or treatment with or without androgen deprivation. The 5-year biochemical disease-free survival (b-DFS) and disease-specific survival were 98% {+-} 1.9% and 100%, respectively. Conclusion: Intensity-modulated radiotherapy hypofractionated boost dose escalation under stereotactic conditions was feasible, and showed excellent outcomes with acceptable long-term toxicity. This approach may well be considered an alternative to high-dose-rate brachytherapy.},
doi = {10.1016/j.ijrobp.2009.07.1689},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 78,
place = {United States},
year = {2010},
month = {9}
}