Salvage Radiotherapy to the Prostatic Fossa Using Volumetric-modulated Arc Therapy: Early Results
| Autor: | KK Yuen, Cmm Lui, S.Y. Tung, Fcs Wong, WH Mui, Gml Law, Ekc Lee, Mkh Chan |
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| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Fossa biology Prostatectomy business.industry Urinary system medicine.medical_treatment Rectum Urinary incontinence medicine.disease biology.organism_classification Surgery Radiation therapy Prostate cancer medicine.anatomical_structure medicine Nocturia Radiology Nuclear Medicine and imaging Radiology medicine.symptom business |
| Zdroj: | Hong Kong Journal of Radiology. 16:191-197 |
| ISSN: | 2223-6619 |
| DOI: | 10.12809/hkjr1313173 |
| Popis: | Objectives: Volumetric-modulated arc therapy (VMAT) is better than intensity-modulated radiotherapy (IMRT) in terms of its plan qualities and efficiency for the treatment of prostate cancer. It remains unclear whether its use in salvage radiotherapy to prostatic fossae is safe and effective. Herein we report the dosimetric and clinical results of salvage radiotherapy to prostatic fossae using VMAT. Methods: Fifteen consecutive patients with a rising prostate-specific antigen after radical prostatectomy in our institution received salvage radiotherapy using VMAT. Prostate-specific antigen control and acute toxicities within 1 year after treatment were retrospectively reviewed. For comparison, IMRT plans were also generated for 12 of these patients and the quality of these plans in terms of organ-at-risk sparing (volume of bladder and rectum receiving 60 and 70 Gy), target coverage (conformation number and the prescribed dose of D90), and the number of monitor units. Results: After salvage radiotherapy using VMAT, all patients had a decrease in their prostate-specific antigen with a complete response rate of 87%. The recorded toxicities were rectal bleeding, tenesmus, urinary frequency, nocturia, and urinary incontinence. After a median follow-up of 20 months, two patients endured treatment failure. There was no significant difference between the VMAT and IMRT plans in terms of quality. The mean number of monitor units by VMAT (488) was significantly smaller than that used by IMRT (519) [p < 0.001]. The mean beam-on time was 171 (range, 92-228) seconds with treatment delivered by VMAT. Conclusions: It is efficient, effective, and safe to use VMAT as salvage radiotherapy to the prostatic fossa. |
| Databáze: | OpenAIRE |
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