OBJECTIVE: To investigate whether patient-reported quality of life after high-dose external beam intensity-modulated radiotherapy for prostate cancer can be improved by decreasing planning target volume margins while using real-time tumor tracking. METHODS: Study patients underwent radiotherapy with nominal 3-mm margins and electromagnetic real-time tracking. Morbidity was assessed before and at the end of radiotherapy using Expanded Prostate Cancer Index Composite (EPIC) questionnaires. Changes in scores were compared between the Assessing Impact of Margin Reduction (AIM) study cohort and the comparator Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment (PROST-QA) cohort, treated with conventional margins. RESULTS: The 64 patients in the prospective AIM study had generally less favorable clinical characteristics than the 153 comparator patients. Study patients had similar or slightly poorer pretreatment EPIC scores than comparator patients in bowel, urinary, and sexual domains. AIM patients receiving radiotherapy had less bowel morbidity than the comparator group as measured by changes in mean bowel and/or rectal domain EPIC scores from pretreatment to 2 months after start of treatment (-1.5 vs -16.0, P = .001). Using a change in EPIC score >0.5 baseline standard deviation as the measure of clinical relevance, AIM study patients experienced meaningful decline in only 1 health-related quality of life domain (urinary) whereas decline in 3 health-related quality of life domains (urinary, sexual, and bowel/rectal) was observed in the PROST-QA comparator cohort. CONCLUSIONS: Prostate cancer patients treated with reduced margins and tumor tracking had less radiotherapy-related morbidity than their counterparts treated with conventional margins. Highly contoured intensity-modulated radiotherapy shows promise as a successful strategy for reducing morbidity in prostate cancer treatment. Copyright 2010 Elsevier Inc. All rights reserved.
OBJECTIVE: To investigate whether patient-reported quality of life after high-dose external beam intensity-modulated radiotherapy for prostate cancer can be improved by decreasing planning target volume margins while using real-time tumor tracking. METHODS: Study patients underwent radiotherapy with nominal 3-mm margins and electromagnetic real-time tracking. Morbidity was assessed before and at the end of radiotherapy using Expanded Prostate Cancer Index Composite (EPIC) questionnaires. Changes in scores were compared between the Assessing Impact of Margin Reduction (AIM) study cohort and the comparator Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment (PROST-QA) cohort, treated with conventional margins. RESULTS: The 64 patients in the prospective AIM study had generally less favorable clinical characteristics than the 153 comparator patients. Study patients had similar or slightly poorer pretreatment EPIC scores than comparator patients in bowel, urinary, and sexual domains. AIM patients receiving radiotherapy had less bowel morbidity than the comparator group as measured by changes in mean bowel and/or rectal domain EPIC scores from pretreatment to 2 months after start of treatment (-1.5 vs -16.0, P = .001). Using a change in EPIC score >0.5 baseline standard deviation as the measure of clinical relevance, AIM study patients experienced meaningful decline in only 1 health-related quality of life domain (urinary) whereas decline in 3 health-related quality of life domains (urinary, sexual, and bowel/rectal) was observed in the PROST-QA comparator cohort. CONCLUSIONS:Prostate cancerpatients treated with reduced margins and tumor tracking had less radiotherapy-related morbidity than their counterparts treated with conventional margins. Highly contoured intensity-modulated radiotherapy shows promise as a successful strategy for reducing morbidity in prostate cancer treatment. Copyright 2010 Elsevier Inc. All rights reserved.
Authors: Deborah A Kuban; Susan L Tucker; Lei Dong; George Starkschall; Eugene H Huang; M Rex Cheung; Andrew K Lee; Alan Pollack Journal: Int J Radiat Oncol Biol Phys Date: 2007-08-31 Impact factor: 7.038
Authors: Stephanie T H Peeters; Wilma D Heemsbergen; Peter C M Koper; Wim L J van Putten; Annerie Slot; Michel F H Dielwart; Johannes M G Bonfrer; Luca Incrocci; Joos V Lebesque Journal: J Clin Oncol Date: 2006-05-01 Impact factor: 44.544
Authors: Dale W Litzenberg; James M Balter; Scott W Hadley; Howard M Sandler; Twyla R Willoughby; Patrick A Kupelian; Lisa Levine Journal: Int J Radiat Oncol Biol Phys Date: 2006-03-20 Impact factor: 7.038
Authors: David P Dearnaley; Matthew R Sydes; John D Graham; Edwin G Aird; David Bottomley; Richard A Cowan; Robert A Huddart; Chakiath C Jose; John Hl Matthews; Jeremy Millar; A Rollo Moore; Rachel C Morgan; J Martin Russell; Christopher D Scrase; Richard J Stephens; Isabel Syndikus; Mahesh K B Parmar Journal: Lancet Oncol Date: 2007-06 Impact factor: 41.316
Authors: Phillip J Gray; Jonathan J Paly; Beow Y Yeap; Martin G Sanda; Howard M Sandler; Jeff M Michalski; James A Talcott; John J Coen; Daniel A Hamstra; William U Shipley; Stephen M Hahn; Anthony L Zietman; Justin E Bekelman; Jason A Efstathiou Journal: Cancer Date: 2013-02-22 Impact factor: 6.860
Authors: Scott C Morgan; Karen Hoffman; D Andrew Loblaw; Mark K Buyyounouski; Caroline Patton; Daniel Barocas; Soren Bentzen; Michael Chang; Jason Efstathiou; Patrick Greany; Per Halvorsen; Bridget F Koontz; Colleen Lawton; C Marc Leyrer; Daniel Lin; Michael Ray; Howard Sandler Journal: J Clin Oncol Date: 2018-10-11 Impact factor: 44.544
Authors: Bradford S Hoppe; Jeff M Michalski; Nancy P Mendenhall; Christopher G Morris; Randal H Henderson; Romaine C Nichols; William M Mendenhall; Christopher R Williams; Meredith M Regan; Jonathan J Chipman; Catrina M Crociani; Howard M Sandler; Martin G Sanda; Daniel A Hamstra Journal: Cancer Date: 2013-12-30 Impact factor: 6.860
Authors: Jin Aun Ng; Jeremy T Booth; Per R Poulsen; Walther Fledelius; Esben Schjødt Worm; Thomas Eade; Fiona Hegi; Andrew Kneebone; Zdenka Kuncic; Paul J Keall Journal: Int J Radiat Oncol Biol Phys Date: 2012-09-11 Impact factor: 7.038
Authors: Wendy Harris; Ellen Yorke; Henry Li; Christian Czmielewski; Mohit Chawla; Robert P Lee; Alexandra Hotca-Cho; Dominique McKnight; Andreas Rimner; D Michael Lovelock Journal: Med Phys Date: 2022-03-03 Impact factor: 4.071
Authors: Ronald C Chen; Peter Chang; Richard J Vetter; Himansu Lukka; William A Stokes; Martin G Sanda; Deborah Watkins-Bruner; Bryce B Reeve; Howard M Sandler Journal: J Natl Cancer Inst Date: 2014-07-08 Impact factor: 13.506