Phase I Trial of MRI-Guided Prostate Cancer Lattice Extreme Ablative Dose (LEAD) Boost Radiation Therapy
| Autor: | Charles M. Lynne, Matthew C. Abramowitz, Radka Stoyanova, Deukwoo Kwon, Alan Pollack, Isildinha M. Reis, Xiaodong Wu, Vivek N. Patel, Brian Marples, Matthew T. Studenski, Elizabeth Bossart, Merce Jorda, Javier Casillas, Felix M. Chinea |
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| Rok vydání: | 2019 |
| Předmět: |
Ablation Techniques
Adult Male Cancer Research Phases of clinical research Article 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences Prostate cancer 0302 clinical medicine Randomized controlled trial Prostate law Medicine Humans Radiology Nuclear Medicine and imaging Aged Aged 80 and over Radiation medicine.diagnostic_test business.industry Genitourinary system Standard treatment Prostatic Neoplasms Seminal Vesicles Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Toxicity Feasibility Studies Safety business Nuclear medicine Tomography X-Ray Computed Radiotherapy Image-Guided |
| Zdroj: | Int J Radiat Oncol Biol Phys |
| ISSN: | 1879-355X |
| Popis: | Purpose A phase I clinical trial was designed to test the feasibility and toxicity of administering high-dose spatially fractionated radiation therapy to magnetic resonance imaging (MRI)–defined prostate tumor volumes, in addition to standard treatment. Methods and Materials We enrolled 25 men with favorable to high-risk prostate cancer and 1 to 3 suspicious multiparametric MRI (mpMRI) gross tumor volumes (GTVs). The mpMRI-GTVs were treated on day 1 with 12 to 14 Gy via dose cylinders using a lattice extreme ablative dose technique. The entire prostate, along with the proximal seminal vesicles, was then treated to 76 Gy at 2 Gy/fraction. For some high-risk patients, the distal seminal vesicles and pelvic lymph nodes received 56 Gy at 1.47 Gy/fraction concurrently in 38 fractions. The total dose to the lattice extreme ablative dose cylinder volume(s) was 88 to 90 Gy (112-123 Gy in 2.0 Gy equivalents, assuming an α-to-β ratio of 3). Results Dosimetric parameters were satisfactorily met. Median follow-up was 66 months. There were no grade 3 acute/subacute genitourinary or gastrointestinal adverse events. Maximum late genitourinary toxicity was grade 1 in 15 (60%), grade 2 in 4 (16%), and grade 4 in 1 (4%; sepsis after a posttreatment transurethral resection). Maximum late gastrointestinal toxicity was grade 1 in 11 (44%) and grade 2 in 4 (16%). Two patients experienced biochemical failure. Conclusions External beam radiation therapy delivered with an upfront spatially fractionated, stereotactic high-dose mpMRI-GTV boost is feasible and was not associated with any unexpected events. The technique is now part of a follow-up phase II randomized trial. |
| Databáze: | OpenAIRE |
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