Open AccessIntensity‐modulated pelvic radiation therapy and simultaneous integrated boost to the prostate area in patients with high‐risk prostate cancer: a preliminary report of disease control
Author(s) -
Saracino Biancamaria,
Petrongari Maria Grazia,
Marzi Simona,
Bruzzaniti Vicente,
Sara Gomellini,
Arcangeli Stefano,
Arcangeli Giorgio,
Pinnarò Paola,
Giordano Carolina,
Ferraro Anna Maria,
Strigari Lidia
Publication year - 2014
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.278
Subject(s) - medicine , prostate cancer , radiation therapy , urology , prostate , toxicity , colorectal cancer , urinary system , lymph node , metastasis , oncology , surgery , cancer
The aim of the study was to report the clinical results in patients with high‐risk prostate cancer treated with pelvic intensity‐modulated radiation therapy ( IMRT ) and simultaneous integrated boost ( SIB ) to the prostate area. A total of 110 patients entered our study, 37 patients presented with localized prostate cancer and radiological evidence of node metastases or ≥15% estimated risk of lymph node ( LN ) involvement, while 73 patients underwent postoperative adjuvant or salvage irradiation for biochemical or residual/recurrent disease, LN metastases, or high risk of harboring nodal metastases. All patients received androgen deprivation therapy ( ADT ) for 2 years. The median follow‐up was 56.5 months. For the whole patient group, the 3‐ and 5‐year freedom from biochemical failure were 82.6% and 74.6%, respectively, with a better outcome in patients treated with radical approach. The 3‐ and 5‐year freedom from local failure were 94.4% and 90.2%, respectively, while the 3‐ and 5‐year distant metastasis‐free survival were 87.8% and 81.7%, respectively. For all study patients, the rate of freedom from G2 acute rectal, intestinal, and urinary toxicities was 60%, 77%, and 61%, respectively. There was no G3 acute toxicity, ≥G2 late intestinal toxicity, or G3 late urinary or rectal toxicity. The 3‐ and 5‐year ≥G2 freedom from late rectal toxicity rate were 98% and 95%, respectively, while the 3‐ and 5‐year ≥G2 freedom from late urinary toxicity rate were 95% and 88%, respectively. The study concludes that pelvic IMRT and SIB to the prostatic area in association with 2‐year ADT was a well‐tolerated technique, providing high disease control in patients with prostate cancer requiring LN treatment.