Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Whole pelvic intensity-modulated radiotherapy for high-risk prostate cancer: a preliminary report

  • Joo, Ji Hyeon (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Yeon Joo (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Young Seok (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Eun Kyung (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jong Hoon (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang-Wook (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Si Yeol (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yoon, Sang Min (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Su Ssan (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Jin-Hong (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jeong, Yuri (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Hanjong (Department of Urology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Choung-Soo (Department of Urology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jae-Lyun (Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Seung Do (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2013.09.16
  • Accepted : 2013.10.18
  • Published : 2013.12.31
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Abstract

Purpose: To assess the clinical efficacy and toxicity of whole pelvic intensity-modulated radiotherapy (WP-IMRT) for high-risk prostate cancer. Materials and Methods: Patients with high-risk prostate cancer treated between 2008 and 2013 were reviewed. The study included patients who had undergone WP-IMRT with image guidance using electronic portal imaging devices and/or cone-beam computed tomography. The endorectal balloon was used in 93% of patients. Patients received either 46 Gy to the whole pelvis plus a boost of up to 76 Gy to the prostate in 2 Gy daily fractions, or 44 Gy to the whole pelvis plus a boost of up to 72.6 Gy to the prostate in 2.2 Gy fractions. Results: The study cohort included 70 patients, of whom 55 (78%) had a Gleason score of 8 to 10 and 50 (71%) had a prostate-specific antigen level > 20 ng/mL. The androgen deprivation therapy was combined in 62 patients. The biochemical failure-free survival rate was 86.7% at 2 years. Acute any grade gastrointestinal (GI) and genitourinary (GU) toxicity rates were 47% and 73%, respectively. The actuarial rate of late grade 2 or worse toxicity at 2 years was 12.9% for GI, and 5.7% for GU with no late grade 4 toxicity. Conclusion: WP-IMRT was well tolerated with no severe acute or late toxicities, resulting in at least similar biochemical control to that of the historic control group with a small field. The long-term efficacy and toxicity will be assessed in the future, and a prospective randomized trial is needed to verify these findings.

Keywords

References

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