DOAJ Open Access 2020

Ten-Year Results From a Phase II Study on Image Guided, Intensity Modulated Radiation Therapy With Simultaneous Integrated Boost in High-Risk Prostate Cancer

Christian Ekanger, MD Svein Inge Helle, MD, PhD Daniel Heinrich, MD Dag Clement Johannessen, MD Ása Karlsdóttir, MD, PhD +6 lainnya

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Abstrak

Purpose: There is no consensus on how to treat high-risk prostate cancer, and long-term results from hypofractionated radiation therapy are lacking. We report 10-year results after image guided, intensity modulated radiation therapy with hypofractionated simultaneous integrated boost and elective pelvic field. Methods and Materials: Between 2007 and 2009, 97 consecutive patients with high-risk prostate cancer were included, treated with 2.7 to 2.0 Gy × 25 Gy to the prostate, seminal vesicles, and elective pelvic field. Toxicity was scored according to Radiation Therapy Oncology Group criteria and biochemical disease-free survival (BFS) defined by the Phoenix definition. Patients were subsequently divided into 3 groups: high risk (HR; n = 32), very high risk (VHR; n = 50), and N+/s–prostate-specific antigen (PSA) ≥100 (n = 15). Differences in outcomes were examined using Kaplan-Meier analyses. Results: BFS in the patients at HR and VHR was 64%, metastasis-free survival 80%, prostate cancer-specific survival 90%, and overall survival (OS) 72%. VHR versus HR subgroups demonstrated significantly different BFS, 54% versus 79% (P = .01). Metastasis-free survival and prostate cancer-specific survival in the VHR group versus HR group were 76% versus 87% (P = .108) and 74% versus 100% (P = .157). Patients reaching nadir PSA <0.1 (n = 80) had significantly better outcomes than the rest (n = 17), with BFS 70% versus 7% (P < .001). Acute grade 2 gastrointestinal tract (GI) and genitourinary tract (GU) toxicity occurred in 27% and 40%, grade 3 GI and GU toxicity in 1% and 3%. Late GI and GU grade 2 toxicity occurred in 1% and 8%. Conclusions: High-risk prostate cancer patients obtained favorable 10-year outcomes with low toxicity. There were significantly better results in the HR versus the VHR group, both better than the N+/PSA ≥100 group. A nadir PSA value < 0.1 predicted good prognosis.

Topik & Kata Kunci

Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens

Penulis (11)

Christian Ekanger, MD

Svein Inge Helle, MD, PhD

Daniel Heinrich, MD

Dag Clement Johannessen, MD

Ása Karlsdóttir, MD, PhD

Yngve Nygård, MD, PhD

Ole Johan Halvorsen, MD, PhD

Lars Reisæter, MD

Rune Kvåle, MD, PhD

Liv Bolstad Hysing, M.Sc., PhD

Olav Dahl, MD, PhD

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MD, C.E., PhD, S.I.H.M., MD, D.H., MD, D.C.J., PhD, Á.K.M., PhD, Y.N.M. et al. (2020). Ten-Year Results From a Phase II Study on Image Guided, Intensity Modulated Radiation Therapy With Simultaneous Integrated Boost in High-Risk Prostate Cancer. https://doi.org/10.1016/j.adro.2019.11.007

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Informasi Jurnal

Tahun Terbit: 2020
Sumber Database: DOAJ
DOI: 10.1016/j.adro.2019.11.007
Akses: Open Access ✓