Long-term outcome of a moderately hypofractionated, intensity-modulated radiotherapy approach using an endorectal balloon for patients with localized prostate cancer
Abstract Background Technical advances in radiotherapy delivery have simultaneously enabled dose escalation and enhanced bladder and rectal sparing. However, the optimal radiation fractionation regimen for localized prostate cancer is unclear. Laboratory and clinical evidence suggest that hypofracti...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-04-01
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| Series: | Cancer Communications |
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| Online Access: | http://link.springer.com/article/10.1186/s40880-018-0281-4 |
| _version_ | 1818281472323223552 |
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| author | Bin S. Teh Gary D. Lewis Weiyuan Mai Ramiro Pino Hiromichi Ishiyama Edward Brian Butler |
| author_facet | Bin S. Teh Gary D. Lewis Weiyuan Mai Ramiro Pino Hiromichi Ishiyama Edward Brian Butler |
| author_sort | Bin S. Teh |
| collection | DOAJ |
| description | Abstract Background Technical advances in radiotherapy delivery have simultaneously enabled dose escalation and enhanced bladder and rectal sparing. However, the optimal radiation fractionation regimen for localized prostate cancer is unclear. Laboratory and clinical evidence suggest that hypofractionation may improve the therapeutic ratio of radiotherapy. We report our institutional outcomes using moderately hypofractionated, intensity-modulated radiotherapy (IMRT), and an endorectal balloon, with emphasis on long-term biochemical control and treatment-related adverse events in patients with localized prostate cancer. Methods Between January 1997 and April 2004, 596 patients with cT1–T3 prostate cancer underwent IMRT using a moderate hypofractionation regimen (76.70 Gy at 2.19 Gy/fraction) with an endorectal balloon. Using D’Amico classification, 226 (37.9%), 264 (44.3%), and 106 (17.8%) patients had low-, intermediate-, or high-risk disease, respectively. The majority of intermediate- and high-risk patients received androgen deprivation therapy. Biochemical relapse-free survival (bRFS) was evaluated using 2005 Phoenix criteria and estimated using the Kaplan–Meier method. Results The median follow-up was 62 months. Overall 5- and 10-year bRFS rates were 92.7% and 87.7%. For low-, intermediate-, and high-risk patients, the 5-year bRFS rates were 96.9%, 93.3%, and 82.0%, respectively; the 10-year bRFS rates were 91.4%, 89.3%, and 76.2%, respectively. Prostate-specific antigen, Gleason score, and T stage were significant predictors of bRFS (all P < 0.01). The 5-year rates of severe (≥ Grade 3) adverse events were very low: 1.2% for gastrointestinal events and 1.1% for genitourinary events. Conclusions Long-term outcomes after moderately hypofractionated IMRT are encouraging. Moderate hypofractionation represents a safe, efficacious, alternative regimen in the treatment of localized prostate cancer. |
| first_indexed | 2024-12-13T00:05:40Z |
| format | Article |
| id | doaj.art-0118759e289b40cbabec5024f52b1d95 |
| institution | Directory Open Access Journal |
| issn | 2523-3548 |
| language | English |
| last_indexed | 2024-12-13T00:05:40Z |
| publishDate | 2018-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Communications |
| spelling | doaj.art-0118759e289b40cbabec5024f52b1d952022-12-22T00:06:15ZengWileyCancer Communications2523-35482018-04-013811910.1186/s40880-018-0281-4Long-term outcome of a moderately hypofractionated, intensity-modulated radiotherapy approach using an endorectal balloon for patients with localized prostate cancerBin S. Teh0Gary D. Lewis1Weiyuan Mai2Ramiro Pino3Hiromichi Ishiyama4Edward Brian Butler5Department of Radiation Oncology, Houston Methodist Hospital, Cancer Center, and Research Institute, Weill Cornell Medical CollegeDepartment of Radiation Oncology, Houston Methodist Hospital, Cancer Center, and Research Institute, Weill Cornell Medical CollegeDepartment of Radiation Oncology, Baylor College of MedicineDepartment of Radiation Oncology, Houston Methodist Hospital, Cancer Center, and Research Institute, Weill Cornell Medical CollegeDepartment of Radiology and Radiation Oncology, Kitasato University School of MedicineDepartment of Radiation Oncology, Houston Methodist Hospital, Cancer Center, and Research Institute, Weill Cornell Medical CollegeAbstract Background Technical advances in radiotherapy delivery have simultaneously enabled dose escalation and enhanced bladder and rectal sparing. However, the optimal radiation fractionation regimen for localized prostate cancer is unclear. Laboratory and clinical evidence suggest that hypofractionation may improve the therapeutic ratio of radiotherapy. We report our institutional outcomes using moderately hypofractionated, intensity-modulated radiotherapy (IMRT), and an endorectal balloon, with emphasis on long-term biochemical control and treatment-related adverse events in patients with localized prostate cancer. Methods Between January 1997 and April 2004, 596 patients with cT1–T3 prostate cancer underwent IMRT using a moderate hypofractionation regimen (76.70 Gy at 2.19 Gy/fraction) with an endorectal balloon. Using D’Amico classification, 226 (37.9%), 264 (44.3%), and 106 (17.8%) patients had low-, intermediate-, or high-risk disease, respectively. The majority of intermediate- and high-risk patients received androgen deprivation therapy. Biochemical relapse-free survival (bRFS) was evaluated using 2005 Phoenix criteria and estimated using the Kaplan–Meier method. Results The median follow-up was 62 months. Overall 5- and 10-year bRFS rates were 92.7% and 87.7%. For low-, intermediate-, and high-risk patients, the 5-year bRFS rates were 96.9%, 93.3%, and 82.0%, respectively; the 10-year bRFS rates were 91.4%, 89.3%, and 76.2%, respectively. Prostate-specific antigen, Gleason score, and T stage were significant predictors of bRFS (all P < 0.01). The 5-year rates of severe (≥ Grade 3) adverse events were very low: 1.2% for gastrointestinal events and 1.1% for genitourinary events. Conclusions Long-term outcomes after moderately hypofractionated IMRT are encouraging. Moderate hypofractionation represents a safe, efficacious, alternative regimen in the treatment of localized prostate cancer.http://link.springer.com/article/10.1186/s40880-018-0281-4Prostate cancerIntensity-modulated radiotherapyModerate hypofractionation |
| spellingShingle | Bin S. Teh Gary D. Lewis Weiyuan Mai Ramiro Pino Hiromichi Ishiyama Edward Brian Butler Long-term outcome of a moderately hypofractionated, intensity-modulated radiotherapy approach using an endorectal balloon for patients with localized prostate cancer Cancer Communications Prostate cancer Intensity-modulated radiotherapy Moderate hypofractionation |
| title | Long-term outcome of a moderately hypofractionated, intensity-modulated radiotherapy approach using an endorectal balloon for patients with localized prostate cancer |
| title_full | Long-term outcome of a moderately hypofractionated, intensity-modulated radiotherapy approach using an endorectal balloon for patients with localized prostate cancer |
| title_fullStr | Long-term outcome of a moderately hypofractionated, intensity-modulated radiotherapy approach using an endorectal balloon for patients with localized prostate cancer |
| title_full_unstemmed | Long-term outcome of a moderately hypofractionated, intensity-modulated radiotherapy approach using an endorectal balloon for patients with localized prostate cancer |
| title_short | Long-term outcome of a moderately hypofractionated, intensity-modulated radiotherapy approach using an endorectal balloon for patients with localized prostate cancer |
| title_sort | long term outcome of a moderately hypofractionated intensity modulated radiotherapy approach using an endorectal balloon for patients with localized prostate cancer |
| topic | Prostate cancer Intensity-modulated radiotherapy Moderate hypofractionation |
| url | http://link.springer.com/article/10.1186/s40880-018-0281-4 |
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