TY - JOUR
T1 - Postoperative intensity-modulated radiotherapy with simultaneous integrated boost in prostate cancer: A dose-escalation trial
AU - Ippolito, Edy
AU - Cellini, Numa
AU - Digesu', Cinzia
AU - Cilla, Savino
AU - Mantini, Giovanna
AU - Balducci, Mario
AU - Di Lallo, Alessandra
AU - Deodato, Francesco
AU - Macchia, Gabriella
AU - Massaccesi, Mariangela
AU - Mattiucci, Gian Carlo
AU - Tagliaferri, Luca
AU - Piermattei, Angelo
AU - Cuscunà, Daniele
AU - Morganti, Alessio Giuseppe
PY - 2013
Y1 - 2013
N2 - OBJECTIVES:
To determine the recommended phase II dose of postoperative accelerated intensity modulated radiotherapy (IMRT) for prostate cancer.
MATERIAL AND METHODS:
Step and shoot IMRT with simultaneous integrated boost (SIB) was delivered in 25 fractions over 5 weeks to patients with high risk resected prostate adenocarcinoma (stage pT3-4 and/or positive surgical margins). Pelvic nodes received 45 Gy at 1.8 Gy/fraction; dose escalation was performed only to the prostate bed (planned dose escalation: 56.8 Gy at 2.27 Gy/fraction, 59.7 Gy at 2.39 Gy/fraction, 61.25 Gy at 2.45 Gy/fraction, 62.5 Gy at 2.5 Gy/fraction). Dose-limiting toxicity (DLT) was any grade ≥ 3 acute toxicity (RTOG score).
RESULTS:
Twenty-five patients were treated: 7 patients at the 56.75 Gy dose level, 6 patients at each subsequent dose level. Pathologic stages were: pT2c: 2; pT3a: 11; pT3b: 12; pN0: 22; pN1: 3; R0: 7; R1: 18. Median follow-up time was 19 months (range: 6-36 months). No patient experienced DLT. Grade 1-2 acute rectal and urologic toxicity was common (17 and 22 patients, respectively).
CONCLUSIONS:
The recommended dose was 62.5 Gy in 2.5 Gy/fraction. Postoperative hypofractionated IMRT SIB for prostate cancer seemed to be well tolerated and could be tested in phase II studies.
AB - OBJECTIVES:
To determine the recommended phase II dose of postoperative accelerated intensity modulated radiotherapy (IMRT) for prostate cancer.
MATERIAL AND METHODS:
Step and shoot IMRT with simultaneous integrated boost (SIB) was delivered in 25 fractions over 5 weeks to patients with high risk resected prostate adenocarcinoma (stage pT3-4 and/or positive surgical margins). Pelvic nodes received 45 Gy at 1.8 Gy/fraction; dose escalation was performed only to the prostate bed (planned dose escalation: 56.8 Gy at 2.27 Gy/fraction, 59.7 Gy at 2.39 Gy/fraction, 61.25 Gy at 2.45 Gy/fraction, 62.5 Gy at 2.5 Gy/fraction). Dose-limiting toxicity (DLT) was any grade ≥ 3 acute toxicity (RTOG score).
RESULTS:
Twenty-five patients were treated: 7 patients at the 56.75 Gy dose level, 6 patients at each subsequent dose level. Pathologic stages were: pT2c: 2; pT3a: 11; pT3b: 12; pN0: 22; pN1: 3; R0: 7; R1: 18. Median follow-up time was 19 months (range: 6-36 months). No patient experienced DLT. Grade 1-2 acute rectal and urologic toxicity was common (17 and 22 patients, respectively).
CONCLUSIONS:
The recommended dose was 62.5 Gy in 2.5 Gy/fraction. Postoperative hypofractionated IMRT SIB for prostate cancer seemed to be well tolerated and could be tested in phase II studies.
KW - IMRT
KW - IMRT
UR - http://hdl.handle.net/10807/52194
U2 - 10.1016/j.urolonc.2010.10.005
DO - 10.1016/j.urolonc.2010.10.005
M3 - Article
SN - 1078-1439
VL - 31
SP - 87
EP - 92
JO - Urologic Oncology
JF - Urologic Oncology
ER -
