A Prospective Study of Stereotactic Body Radiotherapy (SBRT) with Concomitant Whole-Pelvic Radiotherapy (WPRT) for High-Risk Localized Prostate Cancer Patients Using 1.5 Tesla Magnetic Resonance Guidance: The Preliminary Clinical Outcome
<b>Background:</b> Conventionally fractionated whole-pelvic nodal radiotherapy (WPRT) improves clinical outcome compared to prostate-only RT in high-risk prostate cancer (HR-PC). MR-guided stereotactic body radiotherapy (MRgSBRT) with concomitant WPRT represents a novel radiotherapy (RT)...
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MDPI AG
2022-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/14/3484 |
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| author | Darren M. C. Poon Jing Yuan Bin Yang Oi-Lei Wong Sin-Ting Chiu George Chiu Kin-Yin Cheung Siu-Ki Yu Raymond W. H. Yung |
| author_facet | Darren M. C. Poon Jing Yuan Bin Yang Oi-Lei Wong Sin-Ting Chiu George Chiu Kin-Yin Cheung Siu-Ki Yu Raymond W. H. Yung |
| author_sort | Darren M. C. Poon |
| collection | DOAJ |
| description | <b>Background:</b> Conventionally fractionated whole-pelvic nodal radiotherapy (WPRT) improves clinical outcome compared to prostate-only RT in high-risk prostate cancer (HR-PC). MR-guided stereotactic body radiotherapy (MRgSBRT) with concomitant WPRT represents a novel radiotherapy (RT) paradigm for HR-PC, potentially improving online image guidance and clinical outcomes. This study aims to report the preliminary clinical experiences and treatment outcome of 1.5 Tesla adaptive MRgSBRT with concomitant WPRT in HR-PC patients. <b>Materials and methods:</b> Forty-two consecutive HR-PC patients (72.5 ± 6.8 years) were prospectively enrolled, treated by online adaptive MRgSBRT (8 Gy(prostate)/5 Gy(WPRT) × 5 fractions) combined with androgen deprivation therapy (ADT) and followed up (median: 251 days, range: 20–609 days). Clinical outcomes were measured by gastrointestinal (GI) and genitourinary (GU) toxicities according to the Common Terminology Criteria for Adverse Events (CTCAE) Scale v. 5.0, patient-reported quality of life (QoL) with EPIC (Expanded Prostate Cancer Index Composite) questionnaire, and prostate-specific antigen (PSA) responses. <b>Results:</b> All MRgSBRT fractions achieved planning objectives and dose specifications of the targets and organs at risk, and they were successfully delivered. The maximum cumulative acute GI/GU grade 1 and 2 toxicity rates were 19.0%/81.0% and 2.4%/7.1%, respectively. The subacute (>30 days) GI/GU grade 1 and 2 toxicity rates were 21.4%/64.3% and 2.4%/2.4%, respectively. No grade 3 toxicities were reported. QoL showed insignificant changes in urinary, bowel, sexual, and hormonal domain scores during the follow-up period. All patients had early post-MRgSBRT biochemical responses, while biochemical recurrence (PSA nadir + 2 ng/mL) occurred in one patient at month 18. <b>Conclusions:</b> To our knowledge, this is the first prospective study that showed the clinical outcomes of MRgSBRT with concomitant WPRT in HR-PC patients. The early results suggested favorable treatment-related toxicities and encouraging patient-reported QoLs, but long-term follow-up is needed to confirm our early results. |
| first_indexed | 2024-03-09T03:36:39Z |
| format | Article |
| id | doaj.art-981e6c0c09844ae9bdf8cc5adaf36e84 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T03:36:39Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-981e6c0c09844ae9bdf8cc5adaf36e842023-12-03T14:48:01ZengMDPI AGCancers2072-66942022-07-011414348410.3390/cancers14143484A Prospective Study of Stereotactic Body Radiotherapy (SBRT) with Concomitant Whole-Pelvic Radiotherapy (WPRT) for High-Risk Localized Prostate Cancer Patients Using 1.5 Tesla Magnetic Resonance Guidance: The Preliminary Clinical OutcomeDarren M. C. Poon0Jing Yuan1Bin Yang2Oi-Lei Wong3Sin-Ting Chiu4George Chiu5Kin-Yin Cheung6Siu-Ki Yu7Raymond W. H. Yung8Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, ChinaResearch Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, ChinaMedical Physics Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, ChinaResearch Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, ChinaDepartment of Radiotherapy, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, ChinaDepartment of Radiotherapy, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, ChinaMedical Physics Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, ChinaMedical Physics Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, ChinaResearch Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China<b>Background:</b> Conventionally fractionated whole-pelvic nodal radiotherapy (WPRT) improves clinical outcome compared to prostate-only RT in high-risk prostate cancer (HR-PC). MR-guided stereotactic body radiotherapy (MRgSBRT) with concomitant WPRT represents a novel radiotherapy (RT) paradigm for HR-PC, potentially improving online image guidance and clinical outcomes. This study aims to report the preliminary clinical experiences and treatment outcome of 1.5 Tesla adaptive MRgSBRT with concomitant WPRT in HR-PC patients. <b>Materials and methods:</b> Forty-two consecutive HR-PC patients (72.5 ± 6.8 years) were prospectively enrolled, treated by online adaptive MRgSBRT (8 Gy(prostate)/5 Gy(WPRT) × 5 fractions) combined with androgen deprivation therapy (ADT) and followed up (median: 251 days, range: 20–609 days). Clinical outcomes were measured by gastrointestinal (GI) and genitourinary (GU) toxicities according to the Common Terminology Criteria for Adverse Events (CTCAE) Scale v. 5.0, patient-reported quality of life (QoL) with EPIC (Expanded Prostate Cancer Index Composite) questionnaire, and prostate-specific antigen (PSA) responses. <b>Results:</b> All MRgSBRT fractions achieved planning objectives and dose specifications of the targets and organs at risk, and they were successfully delivered. The maximum cumulative acute GI/GU grade 1 and 2 toxicity rates were 19.0%/81.0% and 2.4%/7.1%, respectively. The subacute (>30 days) GI/GU grade 1 and 2 toxicity rates were 21.4%/64.3% and 2.4%/2.4%, respectively. No grade 3 toxicities were reported. QoL showed insignificant changes in urinary, bowel, sexual, and hormonal domain scores during the follow-up period. All patients had early post-MRgSBRT biochemical responses, while biochemical recurrence (PSA nadir + 2 ng/mL) occurred in one patient at month 18. <b>Conclusions:</b> To our knowledge, this is the first prospective study that showed the clinical outcomes of MRgSBRT with concomitant WPRT in HR-PC patients. The early results suggested favorable treatment-related toxicities and encouraging patient-reported QoLs, but long-term follow-up is needed to confirm our early results.https://www.mdpi.com/2072-6694/14/14/3484magnetic resonance-guided stereotactic body radiation therapy (MRgSBRT)high-risk prostate cancer (HR-PC)whole-pelvic radiotherapy (WPRT)toxicityquality of life (QoL) |
| spellingShingle | Darren M. C. Poon Jing Yuan Bin Yang Oi-Lei Wong Sin-Ting Chiu George Chiu Kin-Yin Cheung Siu-Ki Yu Raymond W. H. Yung A Prospective Study of Stereotactic Body Radiotherapy (SBRT) with Concomitant Whole-Pelvic Radiotherapy (WPRT) for High-Risk Localized Prostate Cancer Patients Using 1.5 Tesla Magnetic Resonance Guidance: The Preliminary Clinical Outcome Cancers magnetic resonance-guided stereotactic body radiation therapy (MRgSBRT) high-risk prostate cancer (HR-PC) whole-pelvic radiotherapy (WPRT) toxicity quality of life (QoL) |
| title | A Prospective Study of Stereotactic Body Radiotherapy (SBRT) with Concomitant Whole-Pelvic Radiotherapy (WPRT) for High-Risk Localized Prostate Cancer Patients Using 1.5 Tesla Magnetic Resonance Guidance: The Preliminary Clinical Outcome |
| title_full | A Prospective Study of Stereotactic Body Radiotherapy (SBRT) with Concomitant Whole-Pelvic Radiotherapy (WPRT) for High-Risk Localized Prostate Cancer Patients Using 1.5 Tesla Magnetic Resonance Guidance: The Preliminary Clinical Outcome |
| title_fullStr | A Prospective Study of Stereotactic Body Radiotherapy (SBRT) with Concomitant Whole-Pelvic Radiotherapy (WPRT) for High-Risk Localized Prostate Cancer Patients Using 1.5 Tesla Magnetic Resonance Guidance: The Preliminary Clinical Outcome |
| title_full_unstemmed | A Prospective Study of Stereotactic Body Radiotherapy (SBRT) with Concomitant Whole-Pelvic Radiotherapy (WPRT) for High-Risk Localized Prostate Cancer Patients Using 1.5 Tesla Magnetic Resonance Guidance: The Preliminary Clinical Outcome |
| title_short | A Prospective Study of Stereotactic Body Radiotherapy (SBRT) with Concomitant Whole-Pelvic Radiotherapy (WPRT) for High-Risk Localized Prostate Cancer Patients Using 1.5 Tesla Magnetic Resonance Guidance: The Preliminary Clinical Outcome |
| title_sort | prospective study of stereotactic body radiotherapy sbrt with concomitant whole pelvic radiotherapy wprt for high risk localized prostate cancer patients using 1 5 tesla magnetic resonance guidance the preliminary clinical outcome |
| topic | magnetic resonance-guided stereotactic body radiation therapy (MRgSBRT) high-risk prostate cancer (HR-PC) whole-pelvic radiotherapy (WPRT) toxicity quality of life (QoL) |
| url | https://www.mdpi.com/2072-6694/14/14/3484 |
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