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Open Access 01-12-2007 | Research

Simultaneous integrated boost of biopsy proven, MRI defined dominant intra-prostatic lesions to 95 Gray with IMRT: early results of a phase I NCI study

Authors: Anurag K Singh, Peter Guion, Nancy Sears-Crouse, Karen Ullman, Sharon Smith, Paul S Albert, Gabor Fichtinger, Peter L Choyke, Sheng Xu, Jochen Kruecker, Bradford J Wood, Axel Krieger, Holly Ning

Published in: Radiation Oncology | Issue 1/2007

Abstract

Background

To assess the feasibility and early toxicity of selective, IMRT-based dose escalation (simultaneous integrated boost) to biopsy proven dominant intra-prostatic lesions visible on MRI.

Methods

Patients with localized prostate cancer and an abnormality within the prostate on endorectal coil MRI were eligible. All patients underwent a MRI-guided transrectal biopsy at the location of the MRI abnormality. Gold fiducial markers were also placed. Several days later patients underwent another MRI scan for fusion with the treatment planning CT scan. This fused MRI scan was used to delineate the region of the biopsy proven intra-prostatic lesion. A 3 mm expansion was performed on the intra-prostatic lesions, defined as a separate volume within the prostate. The lesion + 3 mm and the remainder of the prostate + 7 mm received 94.5/75.6 Gray (Gy) respectively in 42 fractions. Daily seed position was verified to be within 3 mm.

Results

Three patients were treated. Follow-up was 18, 6, and 3 months respectively. Two patients had a single intra-prostatic lesion. One patient had 2 intra-prostatic lesions. All four intra-prostatic lesions, with margin, were successfully targeted and treated to 94.5 Gy. Two patients experienced acute RTOG grade 2 genitourinary (GU) toxicity. One had grade 1 gastrointestinal (GI) toxicity. All symptoms completely resolved by 3 months. One patient had no acute toxicity.

Conclusion

These early results demonstrate the feasibility of using IMRT for simultaneous integrated boost to biopsy proven dominant intra-prostatic lesions visible on MRI. The treatment was well tolerated.

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Title: Simultaneous integrated boost of biopsy proven, MRI defined dominant intra-prostatic lesions to 95 Gray with IMRT: early results of a phase I NCI study
Authors: Anurag K Singh
Peter Guion
Nancy Sears-Crouse
Karen Ullman
Sharon Smith
Paul S Albert
Gabor Fichtinger
Peter L Choyke
Sheng Xu
Jochen Kruecker
Bradford J Wood
Axel Krieger
Holly Ning
Publication date: 01-12-2007
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2007
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-2-36

At a glance: The STEP trials

Springer Medicine

Simultaneous integrated boost of biopsy proven, MRI defined dominant intra-prostatic lesions to 95 Gray with IMRT: early results of a phase I NCI study

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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