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Open Access 01-12-2012 | Research

Dose-escalation using intensity-modulated radiotherapy for prostate cancer - evaluation of quality of life with and without ¹⁸F-choline PET-CT detected simultaneous integrated boost

Authors: Michael Pinkawa, Marc D Piroth, Richard Holy, Jens Klotz, Victoria Djukic, Nuria Escobar Corral, Mariana Caffaro, Oliver H Winz, Thomas Krohn, Felix M Mottaghy, Michael J Eble

Published in: Radiation Oncology | Issue 1/2012

Abstract

Background

In comparison to the conventional whole-prostate dose escalation, an integrated boost to the macroscopic malignant lesion might potentially improve tumor control rates without increasing toxicity. Quality of life after radiotherapy (RT) with vs. without ¹⁸F-choline PET-CT detected simultaneous integrated boost (SIB) was prospectively evaluated in this study.

Methods

Whole body image acquisition in supine patient position followed 1 h after injection of 178-355MBq ¹⁸F-choline. SIB was defined by a tumor-to-background uptake value ratio > 2 (GTV_PET). A dose of 76Gy was prescribed to the prostate (PTV_prostate) in 2Gy fractions, with or without SIB up to 80Gy. Patients treated with (n = 46) vs. without (n = 21) SIB were surveyed prospectively before (A), at the last day of RT (B) and a median time of two (C) and 19 month (D) after RT to compare QoL changes applying a validated questionnaire (EPIC - expanded prostate cancer index composite).

Results

With a median cut-off standard uptake value (SUV) of 3, a median GTV_PET of 4.0 cm³ and PTV_boost (GTV_PET with margins) of 17.3 cm³ was defined. No significant differences were found for patients treated with vs. without SIB regarding urinary and bowel QoL changes at times B, C and D (mean differences ≤3 points for all comparisons). Significantly decreasing acute urinary and bowel score changes (mean changes > 5 points in comparison to baseline level at time A) were found for patients with and without SIB. However, long-term urinary and bowel QoL (time D) did not differ relative to baseline levels - with mean urinary and bowel function score changes < 3 points in both groups (median changes = 0 points). Only sexual function scores decreased significantly (> 5 points) at time D.

Conclusions

Treatment planning with ¹⁸F-choline PET-CT allows a dose escalation to a macroscopic intraprostatic lesion without significantly increasing toxicity.

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Title: Dose-escalation using intensity-modulated radiotherapy for prostate cancer - evaluation of quality of life with and without 18F-choline PET-CT detected simultaneous integrated boost
Authors: Michael Pinkawa
Marc D Piroth
Richard Holy
Jens Klotz
Victoria Djukic
Nuria Escobar Corral
Mariana Caffaro
Oliver H Winz
Thomas Krohn
Felix M Mottaghy
Michael J Eble
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2012
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-7-14

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Dose-escalation using intensity-modulated radiotherapy for prostate cancer - evaluation of quality of life with and without ¹⁸F-choline PET-CT detected simultaneous integrated boost

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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