Initial experience with stereotactic body radiation therapy for localized prostate cancer using helical tomotherapy.

Autor: Macias VA; Radiation Oncology, Salamanca University Hospital, Paseo de San Vicente, 182, 37007, Salamanca, Spain, victormaciash@gmail.com., Blanco ML, Perez-Romasanta LA
Jazyk: angličtina
Zdroj: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico [Clin Transl Oncol] 2014 Apr; Vol. 16 (4), pp. 380-5. Date of Electronic Publication: 2013 Aug 09.
DOI: 10.1007/s12094-013-1089-y
Abstrakt: Purpose: Single-institution single-arm prospective study. Endpoint: To assess whether there are more than 5 % of men having grade 3 GU or any grade 3 GI acute toxicity during stereotactic body radiation therapy (SBRT) for prostate cancer using helical tomotherapy.
Methods: Since May 2012, 17 prostate cancer patients were treated with helical tomotherapy. The exclusion criteria used are the following: Gleason score ≥8, PSA >20 ng/ml, cT3b-4, IPSS ≥20 and history of acute urinary retention. CTV included the prostate gland and 1 cm of seminal vesicles in the low-risk group (LR) or the seminal vesicles completely in the intermediate (IR) and high-risk (HR) NCCN groups. CTV margins ranged from 2 to 8 mm, while PTV margins were 2 to 9 mm. Patients received eight fractions of 5.48 Gy (LR) or 5.65 Gy (IR, HR) on alternate days. Total equivalent doses at 2 Gy per fraction are 87.4 for LR and 92.3 Gy for IR-HR using an α/β value of 1.5. Correspondent figures for a α/β of 3 are 74.3 Gy and 78.2 Gy, respectively. Megavoltage CT (MVCT) for on-line correction was taken before every fraction.
Results: The patient distribution by risk group is 29, 47 and 24 % for LR, IR and HR, respectively. 82 % received neoadjuvant-concomitant hormonal therapy. Acute GU toxicity grade 1, 2 and 3 was found in 70, 6 and 0 % of men. GI toxicity was observed in 50, 0 and 0. After 136 MVCT, the standard deviation of the mean individual corrections in the anterior-posterior direction was 2.5 mm.
Conclusion: SBRT for prostate cancer using helical tomotherapy is feasible. Initial results show an early toxicity profile no worse than SBRT delivered with robotic radiosurgery or conventionally fractionated radiotherapy.
Databáze: MEDLINE
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