Rihito Aizawa1, Kiyonao Nakamura1, Yoshiki Norihisa1,2, Takashi Ogata1, Takahiro Inoue3,4, Toshinari Yamasaki3,5, Takashi Kobayashi3, Shusuke Akamatsu3, Osamu Ogawa3, Takashi Mizowaki6. 1. Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8507, Japan. 2. Department of Radiation Oncology, Bellland General Hospital, 500-3, Higashiyama, Naka-ku, Sakai-shi, Osaka, 599-8247, Japan. 3. Department of Urology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8507, Japan. 4. Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi, Mie, 514-8507, Japan. 5. Department of Urology, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminami-cho, Chuo-ku, Kobe-shi, Hyogo, 650-0047, Japan. 6. Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8507, Japan. mizo@kuhp.kyoto-u.ac.jp.
Abstract
BACKGROUND: The aim of this study was to evaluate the long-term efficacy and safety of whole pelvic intensity-modulated radiation therapy with a simultaneous-integrated boost (WP-SIB-IMRT) for locally advanced prostate cancer (LAPCa). METHODS: All patients with cT3-4N0M0 prostate cancer treated with WP-SIB-IMRT between February 2006 and September 2009 at our institution were analyzed retrospectively. The prescribed dose was 78 Gy to the prostate and 58.5 Gy to the prophylactic pelvic lymph nodal area in 39 fractions delivered using the simultaneous-integrated boost technique. All patients received short-term neoadjuvant androgen-deprivation therapy alone (median 8.3 months). Propensity-score matching (PSM) analysis was performed to evaluate the additional benefit of prophylactic whole pelvic radiation therapy (WPRT), using the cohort of 203 LAPCa patients treated with prostate-only IMRT (PO-IMRT). RESULTS: In total, 47 consecutive patients were analyzed. The median estimated risk of pelvic lymph node involvement was 57.5%. The median follow-up period was 10.5 years. The 10 year prostate cancer-specific survival and biochemical failure (BF) rates were 92.2 and 54.8%, respectively. The 10 year cumulative incidence rates of ≥ grade 2 late genitourinary and gastrointestinal toxicities were 21.6 and 17.2%, respectively. From a total of 250 patients, PSM analysis identified 76 patients with similar characteristics, and no significant difference in BF rates was observed between WP-SIB-IMRT and PO-IMRT cohorts (p = 0.261). CONCLUSIONS: WP-SIB-IMRT for LAPCa was safe over long-term observation, although no clear benefit of WPRT was observed among our small and highly selected cohort. Regarding the additional efficacy of WPRT, further investigations are needed.
BACKGROUND: The aim of this study was to evaluate the long-term efficacy and safety of whole pelvic intensity-modulated radiation therapy with a simultaneous-integrated boost (WP-SIB-IMRT) for locally advanced prostate cancer (LAPCa). METHODS: All patients with cT3-4N0M0 prostate cancer treated with WP-SIB-IMRT between February 2006 and September 2009 at our institution were analyzed retrospectively. The prescribed dose was 78 Gy to the prostate and 58.5 Gy to the prophylactic pelvic lymph nodal area in 39 fractions delivered using the simultaneous-integrated boost technique. All patients received short-term neoadjuvant androgen-deprivation therapy alone (median 8.3 months). Propensity-score matching (PSM) analysis was performed to evaluate the additional benefit of prophylactic whole pelvic radiation therapy (WPRT), using the cohort of 203 LAPCa patients treated with prostate-only IMRT (PO-IMRT). RESULTS: In total, 47 consecutive patients were analyzed. The median estimated risk of pelvic lymph node involvement was 57.5%. The median follow-up period was 10.5 years. The 10 year prostate cancer-specific survival and biochemical failure (BF) rates were 92.2 and 54.8%, respectively. The 10 year cumulative incidence rates of ≥ grade 2 late genitourinary and gastrointestinal toxicities were 21.6 and 17.2%, respectively. From a total of 250 patients, PSM analysis identified 76 patients with similar characteristics, and no significant difference in BF rates was observed between WP-SIB-IMRT and PO-IMRT cohorts (p = 0.261). CONCLUSIONS: WP-SIB-IMRT for LAPCa was safe over long-term observation, although no clear benefit of WPRT was observed among our small and highly selected cohort. Regarding the additional efficacy of WPRT, further investigations are needed.
Authors: Nadeem Pervez; Alex Boychak; Claudia S Drodge; Don Yee; Duc Le; Albert Murtha; Matthew Parliament; John Amanie; Alina Mihai; Colin Field; Marc Mackenzie; Sunita Ghosh; Gino Fallone; Robert Pearcey Journal: Am J Clin Oncol Date: 2017-04 Impact factor: 2.339
Authors: C Franzese; A Fogliata; G R D'Agostino; L Di Brina; T Comito; P Navarria; L Cozzi; M Scorsetti Journal: J Cancer Res Clin Oncol Date: 2017-03-08 Impact factor: 4.553
Authors: Mack Roach; Jennifer Moughan; Colleen A F Lawton; Adam P Dicker; Kenneth L Zeitzer; Elizabeth M Gore; Young Kwok; Michael J Seider; I-Chow Hsu; Alan C Hartford; Eric M Horwitz; Kosj Yamoah; Christopher U Jones; Jeff M Michalski; W Robert Lee; Thomas M Pisansky; Rachel Rabinovitch; Marvin Rotman; Rodger M Pryzant; Harold E Kim; Charles R Thomas; William U Shipley; Howard M Sandler Journal: Lancet Oncol Date: 2018-10-10 Impact factor: 41.316
Authors: S O Asbell; K L Martz; K H Shin; W T Sause; R L Doggett; C A Perez; M V Pilepich Journal: Int J Radiat Oncol Biol Phys Date: 1998-03-01 Impact factor: 7.038
Authors: David Dearnaley; Clare L Griffin; Rebecca Lewis; Philip Mayles; Helen Mayles; Olivia F Naismith; Victoria Harris; Christopher D Scrase; John Staffurth; Isabel Syndikus; Anjali Zarkar; Daniel R Ford; Yvonne L Rimmer; Gail Horan; Vincent Khoo; John Frew; Ramachandran Venkitaraman; Emma Hall Journal: Int J Radiat Oncol Biol Phys Date: 2018-12-06 Impact factor: 7.038
Authors: Stefan Alexander Koerber; Erik Winter; Sonja Katayama; Alla Slynko; Matthias Felix Haefner; Matthias Uhl; Florian Sterzing; Gregor Habl; Kai Schubert; Juergen Debus; Klaus Herfarth Journal: Front Oncol Date: 2019-08-13 Impact factor: 6.244