Hypofractionated Volumetric Modulated Arc Radiotherapy with simultaneous Elective Nodal Irradiation is feasible in prostate cancer patients: A single institution experience

Autor: Mohammed F. Al Otaibi, Ehab M. Khalil, Rana I. Mahmood, Mohamed W. Hegazy
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
VMAT-intensity modulation
medicine.medical_treatment
Saudi Arabia
Urology
lcsh:RC254-282
Disease-Free Survival
Pelvis
030218 nuclear medicine & medical imaging
Hypo-fractionation
Androgen deprivation therapy
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Prostate
Materials Chemistry
Humans
Medicine
Prospective Studies
Radiation Injuries
Prospective cohort study
Aged
Medicine(all)
Aged
80 and over
Univariate analysis
Radiotherapy
business.industry
Prostatic Neoplasms
Middle Aged
Prostate-Specific Antigen
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
Radiation therapy
Prostate-specific antigen
Dose Hypofractionation
medicine.anatomical_structure
030220 oncology & carcinogenesis
Radiation Dose Hypofractionation
Lymph Nodes
Radiotherapy
Intensity-Modulated
Neoplasm Grading
business
Nuclear medicine
Radiotherapy
Image-Guided
Zdroj: Journal of the Egyptian National Cancer Institute, Vol 28, Iss 2, Pp 101-110 (2016)
ISSN: 1110-0362
DOI: 10.1016/j.jnci.2016.04.001
Popis: Purpose To assess feasibility, toxicity and biochemical relapse-free survival (b-RFS) for a group of organ confined (OC) Saudi prostate cancer patients treated by hypo-fractionated Volumetric Modulated Arc Radiation Therapy (VMAT) Simultaneous Integrated Boost (SIB) Elective Nodal Irradiation (ENI) whole pelvic radiotherapy (WPRT). Patients and methods Between March 2009 and January 2014, 29 OC prostate cancer patients; median age 64 years, PS 0–1 were treated in King Faisal Specialist Hospital – Riyadh, Kingdom of Saudi Arabia using VMAT–SIB–ENI–WPRT, to a total dose of 70 Gy in 28 fractions. Twenty Four patients (83%) were treated with neo-adjuvant; concurrent androgen deprivation therapy (ADT). Median follow-up (FU) was 42 months (range: 18–72 months). Results The 3-year actuarial b-RFS for low/intermediate and high risk groups were 100%, and 48%, respectively (p = 0.09) with a median FU period of 34 months (range: 14–53 months). Gleason Score (p = 0.02), and pretreatment PSA (p = 0.01) were predictive for biochemical failure on univariate analysis; with no observed prostate cancer-related deaths. Grade 2 acute/late GI and GU toxicities were 28%/0% and 17%/10% respectively with no reported grade 3/4 toxicities. Four (50%) out of the 8 patients with baseline partial potency, retained sexual function on long term follow-up. Conclusions Hypo-fractionation dose escalation VMAT–SIB–ENI–WPRT using 2 arcs is a feasible technique for intermediate/high risk OC prostate cancer patients, with acceptable rates of acute/late toxicities, much favorable planning target volume (PTV) coverage, and shorter overall treatment time. Prospective randomized controlled trials are encouraged to confirm its equivalence to other fractionation schemes.
Databáze: OpenAIRE
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