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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 2/2021

Open Access 01-02-2021 | Prostate Cancer | Original Article

Moderately hypofractionated radiotherapy for localized prostate cancer: updated long-term outcome and toxicity analysis

Authors: Jörg Tamihardja, Max Schortmann, Ingulf Lawrenz, Stefan Weick, Klaus Bratengeier, Michael Flentje, Matthias Guckenberger, Bülent Polat

Published in: Strahlentherapie und Onkologie | Issue 2/2021

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Abstract

Purpose

Evaluation of long-term outcome and toxicity of moderately hypofractionated radiotherapy using intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost treatment planning and cone beam CT-based image guidance for localized prostate cancer.

Methods

Between 2005 and 2015, 346 consecutive patients with localized prostate cancer received primary radiotherapy using cone beam CT-based image-guided intensity-modulated radiotherapy (IG-IMRT) and volumetric modulated arc therapy (IG-VMAT) with a simultaneous integrated boost (SIB). Total doses of 73.9 Gy (n = 44) and 76.2 Gy (n = 302) to the high-dose PTV were delivered in 32 and 33 fractions, respectively. The low-dose PTV received a dose (D95) of 60.06 Gy in single doses of 1.82 Gy. The pelvic lymph nodes were treated in 91 high-risk patients to 45.5 Gy (D95).

Results

Median follow-up was 61.8 months. The 5‑year biochemical relapse-free survival (bRFS) was 85.4% for all patients and 93.3, 87.4, and 79.4% for low-, intermediate-, and high-risk disease, respectively. The 5‑year prostate cancer-specific survival (PSS) was 94.8% for all patients and 98.7, 98.9, 89.3% for low-, intermediate-, and high-risk disease, respectively. The 5‑year and 10-year overall survival rates were 83.8 and 66.3% and the 5‑year and 10-year freedom from distant metastasis rates were 92.2 and 88.0%, respectively. Cumulative 5‑year late GU toxicity and late GI toxicity grade ≥2 was observed in 26.3 and 12.1% of the patients, respectively. Cumulative 5‑year late grade 3 GU/GI toxicity occurred in 4.0/1.2%.

Conclusion

Moderately hypofractionated radiotherapy using SIB treatment planning and cone beam CT image guidance resulted in high biochemical control and survival with low rates of late toxicity.
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Metadata
Title
Moderately hypofractionated radiotherapy for localized prostate cancer: updated long-term outcome and toxicity analysis
Authors
Jörg Tamihardja
Max Schortmann
Ingulf Lawrenz
Stefan Weick
Klaus Bratengeier
Michael Flentje
Matthias Guckenberger
Bülent Polat
Publication date
01-02-2021
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 2/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-020-01678-w

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