Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Radiation Oncology
Published in: Radiation Oncology 1/2013

Open Access 01-12-2013 | Research

Outcomes of high-dose intensity-modulated radiotherapy alone with 1 cm planning target volume posterior margin for localized prostate cancer

Authors: Rafael Gadia, Élton T Leite, Flavia G Gabrielli, Gustavo N Marta, Fernando F Arruda, Carlos V Abreu, Samir A Hanna, Cecilia K Haddad, João F Silva, Heloisa A Carvalho, Bernardo Garicochea

Published in: Radiation Oncology | Issue 1/2013

Login to get access

Abstract

Background

Clinically localized prostate cancer may be treated by different approaches of radiation therapy. The aim of this study was to report the results of disease control and toxicity in patients with clinically localized prostate cancer treated with high dose IMRT alone with 1 cm PTV posterior margin.

Methods

From September 2001 to April 2008, 140 patients with localized prostate cancer were treated with definitive IMRT (dose ≥ 74 Gy) without hormone therapy. Outcomes were measured from the conclusion of radiotherapy. Biochemical failure was defined as PSA nadir + 2.0 ng/dL. Toxicities were assessed using the NCI-CTCAE-version 3.0. Median follow-up was 58 months.

Results

Biochemical failure occurred in 13.6% of patients. Actuarial 5-year biochemical control rates were 91.7%, 82.5% and 85.9% for low-, intermediate-, and high-risk patients, respectively. Stage T2 patients presented a risk of biochemical failure almost three times higher than stage T1 (RR = 2.91; 95% CI: 1.04; 8.17). Distant metastases occurred in 3 (2%) patients. Five-year metastasis-free and overall survivals were 96% and 97.5%, respectively. Late grade 3 genitourinary and gastrointestinal toxicity rates were, respectively, 1.6% and 3%.

Conclusion

High-dose IMRT alone with 1 cm posterior PTV margin was effective and safe for patients with localized prostate cancer.
Appendix
Available only for authorised users
Literature
1.
Viani GA, Stefano EJ, Afonso SL: Higher-than-conventional radiation doses in localized prostate cancer treatment: a meta-analysis of randomized, controlled trials. Int J Radiat Oncol Biol Phys 2009, 74: 1405-1418. 10.1016/j.ijrobp.2008.10.091CrossRefPubMed
2.
Kuban DA, Tucker SL, Dong L, Starkschall G, Huang EH, Cheung MR, Lee AK: Pollack: long-term results of the M. D. Anderson randomized dose-escalation trial for prostate cancer. Int J Radiat Oncol Biol Phys 2008, 70: 67-74. 10.1016/j.ijrobp.2007.06.054CrossRefPubMed
3.
Alicikus ZA, Yamada Y, Zhang Z, Pei X, Hunt M, Kollmeier M, Cox B, Zelefsky MJ: Ten-year outcomes of high-dose, intensity- modulated radiotherapy for localized prostate cancer. Cancer 2011, 117: 1429-1437. 10.1002/cncr.25467CrossRefPubMed
4.
Scardino P: Update: NCCN prostate cancer clinical practice guidelines. J Natl Compr Canc Netw 2005,3(1):29-33.
5.
Roach M 3rd, Hanks G, Thames H Jr, Schellhammer P, Shipley WU, Sokol GH, Sandler H: 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, 65: 965-974. 10.1016/j.ijrobp.2006.04.029CrossRefPubMed
6.
Hanks GE, Pajak TF, Porter A, Grignon D, Brereton H, Venkatesan V, Horwitz EM, Lawton C, Rosenthal SA, Sandler HM, Shipley WU: Phase III trial of long-term adjuvant androgen deprivation after neoadjuvant hormonal cytoreduction and radiotherapy in locally advanced carcinoma of the prostate: the radiation therapy oncology group protocol 92–02. J Clin Oncol 2003, 21: 3972-3978. 10.1200/JCO.2003.11.023CrossRefPubMed
7.
Bolla M, Collette L, Blank L, Warde P, Dubois JB, Mirimanoff RO, Storme G, Bernier J, Kuten A, Sternberg C, Mattelaer J, Lopez Torecilla J, Pfeffer JR, Lino Cutajar C, Zurlo A, Pierart M: Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial. Lancet 2002, 360: 103-106. 10.1016/S0140-6736(02)09408-4CrossRefPubMed
8.
Pilepich MV, Winter K, John MJ, Mesic JB, Sause W, Rubin P, Lawton C, Machtay M, Grignon D: Phase III radiation therapy oncology group (RTOG) trial 86–10 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001, 50: 1243-1252. 10.1016/S0360-3016(01)01579-6CrossRefPubMed
9.
Denham JW, Steigler A, Lamb DS, Joseph D, Mameghan H, Turner S, Matthews J, Franklin I, Atkinson C, North J, Poulsen M, Christie D, Spry NA, Tai KH, Wynne C, Duchesne G, Kovacev O, D’Este C: Short-term androgen deprivation and radiotherapy for locally advanced prostate cancer: results from the trans-tasman radiation oncology group 96.01 randomised controlled trial. Lancet Oncol 2005, 6: 841-850. 10.1016/S1470-2045(05)70348-XCrossRefPubMed
10.
D’Amico AV, Manola J, Loffredo M, Renshaw AA, DellaCroce A, Kantoff PW: 6-month androgen suppression plus radiation therapy vs radiation therapy alone for patients with clinically localized prostate cancer: a randomized controlled trial. JAMA 2004, 292: 821-827. 10.1001/jama.292.7.821CrossRefPubMed
11.
Kuban DA, Levy LB, Cheung MR, Lee AK, Choi S, Frank S, Pollack A: Long-term failure patterns and survival in a randomized dose-escalation trial for prostate cancer: who dies of disease? Int J Radiat Oncol Biol Phys 2011, 79: 1310-1317. 10.1016/j.ijrobp.2010.01.006CrossRefPubMed
12.
Nguyen PL, Chen MH, Beckman JA, Beard CJ, Martin NE, Choueiri TK, Hu JC, Hoffman KE, Dosoretz DE, Moran BJ, Salenius SA, Braccioforte MH, Kantoff PW, D’Amico AV, Ennis RD: Influence of androgen deprivation therapy on all-cause mortality in men with high-risk prostate cancer and a history of congestive heart failure or myocardial infarction. Int J Radiat Oncol Biol Phys 2012, 82: 1411-1416. 10.1016/j.ijrobp.2011.04.067CrossRefPubMed
13.
Hanks GE, Hanlon AL, Schultheiss TE, Pinover WH, Movsas B, Epstein BE, Hunt MA: Dose escalation with 3D conformal treatment: five year outcomes, treatment optimization, and future directions. Int J Radiat Oncol Biol Phys 1998, 41: 501-510. 10.1016/S0360-3016(98)00089-3CrossRefPubMed
14.
Zelefsky MJ, Cowen D, Fuks Z, Shike M, Burman C, Jackson A, Venkatramen ES, Leibel SA: Long term tolerance of high dose three-dimensional conformal radiotherapy in patients with localized prostate carcinoma. Cancer 1999, 85: 2460-2468. 10.1002/(SICI)1097-0142(19990601)85:11<2460::AID-CNCR23>3.0.CO;2-NCrossRefPubMed
15.
Pollack A, Zagars GK, Starkschall G, Antolak JA, Lee JJ, Huang E, von Eschenbach AC, Kuban DA, Rosen I: Prostate cancer radiation dose response: results of the M. D. Anderson phase III randomized trial. Int J Radiat Oncol Biol Phys 2002, 53: 1097-1105. 10.1016/S0360-3016(02)02829-8CrossRefPubMed
16.
Zietman AL, DeSilvio ML, Slater JD, Rossi CJ Jr, Miller DW, Adams JA, Shipley WU: Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. JAMA 2005, 294: 1233-1239. 10.1001/jama.294.10.1233CrossRefPubMed
17.
Dearnaley DP, Sydes MR, Graham JD, Aird EG, Bottomley D, Cowan RA, Huddart RA, Jose CC, Matthews JH, Millar J, Moore AR, Morgan RC, Russell JM, Scrase CD, Stephens RJ, Syndikus I, Parmar MK: Escalated-dose versus standard-dose conformal radiotherapy in prostate cancer: first results from the MRC RT01 randomised controlled trial. Lancet Oncol 2007, 8: 475-487. 10.1016/S1470-2045(07)70143-2CrossRefPubMed
18.
Jani AB, Su A, Correa D, Gratzle J: Comparison of late gastrointestinal and genitourinary toxicity of prostate cancer patients undergoing intensity-modulated versus conventional radiotherapy using localized fields. Prostate Cancer Prostatic Dis 2007, 10: 82-86. 10.1038/sj.pcan.4500910CrossRefPubMed
19.
De Meerleer GO, Fonteyne VH, Vakaet L, Villeirs GM, Denoyette L, Verbaeys A, Lummen N, De Neve WJ: Intensity-modulated radiation therapy for prostate cancer: late morbidity and results on biochemical control. Radiother Oncol 2007, 82: 160-166. 10.1016/j.radonc.2006.12.007CrossRefPubMed
20.
Sheets NC, Goldin GH, Meyer AM, Wu Y, Chang Y, Stürmer T, Holmes JA, Reeve BB, Godley PA, Carpenter WR, Chen RC: Intensity-modulated radiation therapy, proton therapy, or conformal radiation therapy and morbidity and disease control in localized prostate cancer. JAMA 2012, 307: 1611-1620. 10.1001/jama.2012.460CrossRefPubMedPubMedCentral
21.
Zelefsky MJ, Levin EJ, Hunt M, Yamada Y, Shippy AM, Jackson A, Amols HI: Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys 2008, 70: 1124-1129. 10.1016/j.ijrobp.2007.11.044CrossRefPubMed
22.
Heemsbergen WD, Hoogeman MS, Witte MG, Peeters ST, Incrocci L, Lebesque JV: Increased risk of biochemical and clinical failure for prostate patients with a large rectum at radiotherapy planning: results from the Dutch trial of 68 Gy versus 78 Gy. Int J Radiat Oncol Biol Phys 2007, 67: 1418-1424. 10.1016/j.ijrobp.2006.11.014CrossRefPubMed
23.
de Crevoisier R, Tucker SL, Dong L, Mohan R, Cheung R, Cox JD, Kuban DA: Increased risk of biochemical and local failure in patients with distended rectum on the planning CT for prostate cancer radiotherapy. Int J Radiat Oncol Biol Phys 2005, 62: 965-973. 10.1016/j.ijrobp.2004.11.032CrossRefPubMed
24.
Engels B, Soete G, Verellen D, Storme G: Conformal arc radiotherapy for prostate cancer: increased biochemical failure in patients with distended rectum on the planning computed tomogram despite image guidance by implanted markers. Int J Radiat Oncol Biol Phys 2009, 74: 388-391. 10.1016/j.ijrobp.2008.08.007CrossRefPubMed
25.
Zelefsky MJ, Kollmeier M, Cox B, Fidaleo A, Sperling D, Pei X, Carver B, Coleman J, Lovelock M, Hunt M: Improved clinical outcomes with high-dose image guided radiotherapy compared with non-IGRT for the treatment of clinically localized prostate cancer. Int J Radiat Oncol Biol Phys 2012, 84: 125-129. 10.1016/j.ijrobp.2011.11.047CrossRefPubMed
Metadata
Title
Outcomes of high-dose intensity-modulated radiotherapy alone with 1 cm planning target volume posterior margin for localized prostate cancer
Authors
Rafael Gadia
Élton T Leite
Flavia G Gabrielli
Gustavo N Marta
Fernando F Arruda
Carlos V Abreu
Samir A Hanna
Cecilia K Haddad
João F Silva
Heloisa A Carvalho
Bernardo Garicochea
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2013
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-8-285

Other articles of this Issue 1/2013

Radiation Oncology 1/2013 Go to the issue

Case report

Carbon-ion radiotherapy for marginal lymph node recurrences of cervical cancer after definitive radiotherapy: a case report

Study protocol

Electrons for intraoperative radiotherapy in selected breast-cancer patients: late results of the Montpellier phase II trial

Research

Livin expression is an independent factor in rectal cancer patients with or without preoperative radiotherapy

Research

Phase II clinical trial of whole-brain irradiation plus three-dimensional conformal boost with concurrent topotecan for brain metastases from lung cancer

Research

Breast reconstruction and post-mastectomy radiation practice

Research

Accurate IMRT fluence verification for prostate cancer patients using ‘in-vivo’ measured EPID images and in-room acquired kilovoltage cone-beam CT scans