Skip to main content

Advertisement

SpringerLink
Log in

Efficacy of pelvic intensity-modulated radiotherapy with hypofractionated simultaneous integrated boost to the prostate for intermediate- and high-risk prostate cancer

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objectives

The objective of this study is to evaluate the efficacy as well as acute and late toxicities of pelvic intensity-modulated radiotherapy (IMRT) with hypofractionated simultaneous integrated boost (SIB) to the prostate for patients with intermediate- and high-risk prostate cancer.

Methods

A retrospective analysis was performed of 66 patients treated definitively with pelvic SIB-IMRT in a prospective fashion; all of whom also received androgen suppression. The IMRT plans were designed to deliver 70 Gy in 28 fractions (2.5 Gy/fraction) to the prostate while simultaneously delivering 50.4 Gy in 28 fractions (1.8 Gy/fraction) to the pelvic lymph nodes.

Results

Forty-four high-risk (GS 8–10, PSA > 20 or ≥ T2c) patients and 22 intermediate-risk (GS7, 10 < PSA < 20 or cT2b) patients received SIB-IMRT. The 3-year and 4-year rates of actuarial freedom from biochemical failure (FFbF) for all patients receiving SIB-IMRT were 89.5 and 83.9 %, respectively. Prostate cancer-specific survival at 3- and 5-year post RT completion was 98.2 and 90.6 %, respectively.

Conclusion

Pelvic IMRT utilizing a simultaneous integrated boost to the prostate appears to be a safe treatment regimen for high- and high-intermediate-risk prostate cancer patients, allowing them to be treated in an accelerated fashion without compromising biochemical control, freedom from distant metastasis, or prostate cancer-specific survival.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kupelian PA, Willoughby TR, Reddy CA et al (2007) Hypofractionated intensity-modulated radiotherapy (70 Gy at 2.5 Gy per fraction) for localized prostate cancer. Cleveland clinic experience. Int J Radiat Oncol Biol Phys 63:1424–1430

    Article  Google Scholar 

  2. Kupelian PA, Thakkar VV, Khuntia D et al (2005) Hypofractionated intensity-modulated radiotherapy (70 Gy at 2.5 Gy per fraction) for localized prostate cancer: long-term outcomes. Int J Radiat Oncol Biol Phys 63:1463–1468

    Article  PubMed  Google Scholar 

  3. Arcangeli G, Saracino B, Gomellini S et al (2010) A prospective phase III randomized trial of hypofractionation versus conventional fractionation in patients with high-risk prostate cancer. Int J Radiat Oncol Biol Phys 78(1):11–18

    Article  PubMed  Google Scholar 

  4. Lukka H, Hayter C, Julian JA, et al. A randomized trial comparing two fractionation schedules for patients with localized prostate cancer. J Clin Oncol 2005: 6132–6138

  5. Yeoh EE, Botten RJ, Butters J et al (2011) Hypofractionated versus conventionally fractionated radiotherapy for prostate carcinoma: final results of phase III randomized trial. Int J Radiat Oncol Biol Phys 81(5):1271–1278

    Article  PubMed  Google Scholar 

  6. Pervez N, Small C, MacKenzie M et al (2010) Acute toxicity in high-risk prostate cancer patients treated with androgen suppression and hypofractionated intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 76(1):57–64

    Article  CAS  PubMed  Google Scholar 

  7. Livsey JE, Cowan RA, Wylie JP (2003) Hypofractionated conformal radiotherapy in carcinoma of the prostate: five-year outcome analysis. Int J Radiat Oncol Biol Phys 57:1254–1259

    Article  PubMed  Google Scholar 

  8. Pollack A, Hanlon AL, Horwitz EM et al (2006) Dosimetry and preliminary acute toxicity in the first 100 men treated for prostate cancer on a randomized hypofractionation dose escalation trial. Int J Radiat Oncol Biol Phys 64:518–526

    Article  PubMed Central  PubMed  Google Scholar 

  9. McCammon R, Rusthoven KE, Kavanagh B et al (2009) Toxicity assessment of pelvic intensity-modulated radiotherapy with hypofractionated simultaneous integrated boost to prostate for intermediate- and high-risk prostate cancer. Int J Radiat Oncol Biol Phys 75(2):413–420

    Article  PubMed  Google Scholar 

  10. Di Muzio N, Fiorino C, Cozzarini C et al (2009) Phase I-II study of hypofractionated simultaneous integrated boost with tomotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 74(2):392–398

    Article  PubMed  Google Scholar 

  11. Arcangeli S, Saracino B, Petrongari MG et al (2007) Analysis of toxicity in patients with high risk prostate cancer treated with intensity-modulated pelvic radiation therapy and simultaneous integrated dose escalation to prostate area. Radiother Oncol 84(2):148–155

    Article  PubMed  Google Scholar 

  12. Lim TS, Cheung PC, Loblaw DA et al (2008) Hypofractionated accelerated radiotherapy using concomitant intensity-modulated radiotherapy boost technique for localized high-risk prostate cancer: acute toxicity results. Int J Radiat Oncol Biol Phys 72(1):85–92

    Article  PubMed  Google Scholar 

  13. Ippolito E, Cellini N, Digesù C et al (2013) Postoperative intensity-modulated radiotherapy with simultaneous integrated boost in prostate cancer: a dose-escalation trial. Urol Oncol 31(1):87–92

    Article  PubMed  Google Scholar 

  14. Engels B, Soete G, Tournel K et al (2009) Helical tomotherapy with simultaneous integrated boost for high-risk and lymph node-positive prostate cancer: early report on acute and late toxicity. Technol Cancer Res Treat 8(5):353–59

    Article  PubMed  Google Scholar 

  15. Roach M 3rd, Hanks G, Thames H Jr, et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys. 2006; 15; 65 (4): 965–74.

  16. Quon H, Cheung PC, Loblaw DA et al (2012) Hypofractionated concomitant intensity-modulated radiotherapy boost for high-risk prostate cancer: late toxicity. Int J Radiat Oncol Biol Phys 82(2):898–905

    Article  PubMed  Google Scholar 

  17. Guckenberger M, Lawrenz I, Flentje M (2014) Moderately hypofractionated radiotherapy for localized prostate cancer: long-term outcome using IMRT and volumetric IGRT. Strahlenther Onkol 190(1):48–53

    Article  CAS  PubMed  Google Scholar 

  18. Valeriani M, Carnevale A, Osti MF, Minniti G, De Sanctis V, Agolli L, Bracci S, Enrici RM (2013) Hypofractionated intensity-modulated simultaneous integrated boost and image-guided radiotherapy in the treatment of high-risk prostate cancer patients: a preliminary report on acute toxicity. Tumori 99(4):474–9

    PubMed  Google Scholar 

  19. Pollack A, Zagars GK, Starkschall G et al (2002) Prostate cancer radiation dose response: results of the MD Anderson phase III randomized trial. Int J Radiat Oncol Biol Phys 53(5):1097–105

    Article  PubMed  Google Scholar 

  20. Peeters ST, Heemsbergen WD, Koper PC et al (2006) Dose-response in radiotherapy for localized prostate cancer: results of the Dutch multicenter randomized phase III trial comparing 68 Gy of radiotherapy with 78 Gy. J Clin Oncol 24(13):1990–6

    Article  PubMed  Google Scholar 

  21. Katz A (2012) Stereotactic body radiotherapy for prostate cancer: ready for prime time? J Radiat Oncol 1(1):17–30

    Article  Google Scholar 

Download references

Conflicts of interest

Krishna Reddy, Tobin Strom, Reed Plimpton, Brian Kavanagh, Jane Petersen, Shandra Wilson, Paul Maroni, and David Raben declare that they have no conflict of interest.

Ethical standards statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Statement of informed consent

All patients provided informed consent prior to receiving treatment. Statement of informed consent for study participation was not applicable, as the study reported here was a retrospective analysis of patients receiving “standard of care” treatment. The manuscript does not contain any specific patient-identifying data.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, University of Toledo School of Medicine, Toledo, OH, USA

    Krishna Reddy

  2. Departments of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA

    Krishna Reddy, Tobin Strom, Reed Plimpton, Brian D. Kavanagh & David Raben

  3. Departments of Urology, University of Colorado School of Medicine, Aurora, CO, USA

    Jane Petersen, Shandra Wilson & Paul Maroni

Authors
  1. Krishna Reddy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tobin Strom
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Reed Plimpton
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brian D. Kavanagh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jane Petersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shandra Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Paul Maroni
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. David Raben
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Krishna Reddy.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Reddy, K., Strom, T., Plimpton, R. et al. Efficacy of pelvic intensity-modulated radiotherapy with hypofractionated simultaneous integrated boost to the prostate for intermediate- and high-risk prostate cancer. J Radiat Oncol 3, 401–407 (2014). https://doi.org/10.1007/s13566-014-0163-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13566-014-0163-6

Keywords

Search

Navigation