Stereotactic body radiation therapy for the treatment of localized prostate cancer in men with underlying inflammatory bowel disease
Abstract Background Historically, IBD has been thought to increase the underlying risk of radiation related toxicity in the treatment of prostate cancer. In the modern era, contemporary radiation planning and delivery may mitigate radiation-related toxicity in this theoretically high-risk cohort. Th...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-07-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13014-021-01850-1 |
| _version_ | 1818442334258331648 |
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| author | Jonathan W. Lischalk Seth Blacksburg Christopher Mendez Michael Repka Astrid Sanchez Todd Carpenter Matthew Witten Jules E. Garbus Andrew Evans Sean P. Collins Aaron Katz Jonathan Haas |
| author_facet | Jonathan W. Lischalk Seth Blacksburg Christopher Mendez Michael Repka Astrid Sanchez Todd Carpenter Matthew Witten Jules E. Garbus Andrew Evans Sean P. Collins Aaron Katz Jonathan Haas |
| author_sort | Jonathan W. Lischalk |
| collection | DOAJ |
| description | Abstract Background Historically, IBD has been thought to increase the underlying risk of radiation related toxicity in the treatment of prostate cancer. In the modern era, contemporary radiation planning and delivery may mitigate radiation-related toxicity in this theoretically high-risk cohort. This is the first manuscript to report clinical outcomes for men diagnosed with prostate cancer and underlying IBD curatively treated with stereotactic body radiation therapy (SBRT). Methods A large institutional database of patients (n = 4245) treated with SBRT for adenocarcinoma of the prostate was interrogated to identify patients who were diagnosed with underlying IBD prior to treatment. All patients were treated with SBRT over five treatment fractions using a robotic radiosurgical platform and fiducial tracking. Baseline IBD characteristics including IBD subtype, pre-SBRT IBD medications, and EPIC bowel questionnaires were reviewed for the IBD cohort. Acute and late toxicity was evaluated using the CTCAE version 5.0. Results A total of 31 patients were identified who had underlying IBD prior to SBRT for the curative treatment of prostate cancer. The majority (n = 18) were diagnosed with ulcerative colitis and were being treated with local steroid suppositories for IBD. No biochemical relapses were observed in the IBD cohort with early follow up. High-grade acute and late toxicities were rare (n = 1, grade 3 proctitis) with a median time to any GI toxicity of 22 months. Hemorrhoidal flare was the most common low-grade toxicity observed (n = 3). Conclusion To date, this is one of the largest groups of patients with IBD treated safely and effectively with radiation for prostate cancer and the only review of patients treated with SBRT. Caution is warranted when delivering therapeutic radiation to patients with IBD, however modern radiation techniques appear to have mitigated the risk of GI side effects. |
| first_indexed | 2024-12-14T18:42:30Z |
| format | Article |
| id | doaj.art-a24a6ca933b04807b213e86839d04035 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-14T18:42:30Z |
| publishDate | 2021-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-a24a6ca933b04807b213e86839d040352022-12-21T22:51:28ZengBMCRadiation Oncology1748-717X2021-07-011611910.1186/s13014-021-01850-1Stereotactic body radiation therapy for the treatment of localized prostate cancer in men with underlying inflammatory bowel diseaseJonathan W. Lischalk0Seth Blacksburg1Christopher Mendez2Michael Repka3Astrid Sanchez4Todd Carpenter5Matthew Witten6Jules E. Garbus7Andrew Evans8Sean P. Collins9Aaron Katz10Jonathan Haas11Department of Radiation Oncology, NYCyberKnife at Perlmutter Cancer Center – Manhattan, Perlmutter Cancer Center at New York University Langone Hospital – Long IslandDepartment of Radiation Medicine, Lenox Hill Hospital – Northwell HealthDepartment of Radiation Oncology, NYCyberKnife at Perlmutter Cancer Center – Manhattan, Perlmutter Cancer Center at New York University Langone Hospital – Long IslandDepartment of Radiation Oncology, NYCyberKnife at Perlmutter Cancer Center – Manhattan, Perlmutter Cancer Center at New York University Langone Hospital – Long IslandDepartment of Radiation Oncology, NYCyberKnife at Perlmutter Cancer Center – Manhattan, Perlmutter Cancer Center at New York University Langone Hospital – Long IslandDepartment of Radiation Oncology, NYCyberKnife at Perlmutter Cancer Center – Manhattan, Perlmutter Cancer Center at New York University Langone Hospital – Long IslandDepartment of Radiation Oncology, NYCyberKnife at Perlmutter Cancer Center – Manhattan, Perlmutter Cancer Center at New York University Langone Hospital – Long IslandDepartment of Surgery, New York University Long Island School of MedicineDepartment of Radiation Oncology, New York University School of MedicineDepartment of Radiation Medicine, Medstar Georgetown University HospitalDepartment of Urology, New York University Long Island School of MedicineDepartment of Radiation Oncology, NYCyberKnife at Perlmutter Cancer Center – Manhattan, Perlmutter Cancer Center at New York University Langone Hospital – Long IslandAbstract Background Historically, IBD has been thought to increase the underlying risk of radiation related toxicity in the treatment of prostate cancer. In the modern era, contemporary radiation planning and delivery may mitigate radiation-related toxicity in this theoretically high-risk cohort. This is the first manuscript to report clinical outcomes for men diagnosed with prostate cancer and underlying IBD curatively treated with stereotactic body radiation therapy (SBRT). Methods A large institutional database of patients (n = 4245) treated with SBRT for adenocarcinoma of the prostate was interrogated to identify patients who were diagnosed with underlying IBD prior to treatment. All patients were treated with SBRT over five treatment fractions using a robotic radiosurgical platform and fiducial tracking. Baseline IBD characteristics including IBD subtype, pre-SBRT IBD medications, and EPIC bowel questionnaires were reviewed for the IBD cohort. Acute and late toxicity was evaluated using the CTCAE version 5.0. Results A total of 31 patients were identified who had underlying IBD prior to SBRT for the curative treatment of prostate cancer. The majority (n = 18) were diagnosed with ulcerative colitis and were being treated with local steroid suppositories for IBD. No biochemical relapses were observed in the IBD cohort with early follow up. High-grade acute and late toxicities were rare (n = 1, grade 3 proctitis) with a median time to any GI toxicity of 22 months. Hemorrhoidal flare was the most common low-grade toxicity observed (n = 3). Conclusion To date, this is one of the largest groups of patients with IBD treated safely and effectively with radiation for prostate cancer and the only review of patients treated with SBRT. Caution is warranted when delivering therapeutic radiation to patients with IBD, however modern radiation techniques appear to have mitigated the risk of GI side effects.https://doi.org/10.1186/s13014-021-01850-1ProstateStereotactic body radiation therapyInflammatory bowel diseaseUlcerative colitisCrohn’s disease |
| spellingShingle | Jonathan W. Lischalk Seth Blacksburg Christopher Mendez Michael Repka Astrid Sanchez Todd Carpenter Matthew Witten Jules E. Garbus Andrew Evans Sean P. Collins Aaron Katz Jonathan Haas Stereotactic body radiation therapy for the treatment of localized prostate cancer in men with underlying inflammatory bowel disease Radiation Oncology Prostate Stereotactic body radiation therapy Inflammatory bowel disease Ulcerative colitis Crohn’s disease |
| title | Stereotactic body radiation therapy for the treatment of localized prostate cancer in men with underlying inflammatory bowel disease |
| title_full | Stereotactic body radiation therapy for the treatment of localized prostate cancer in men with underlying inflammatory bowel disease |
| title_fullStr | Stereotactic body radiation therapy for the treatment of localized prostate cancer in men with underlying inflammatory bowel disease |
| title_full_unstemmed | Stereotactic body radiation therapy for the treatment of localized prostate cancer in men with underlying inflammatory bowel disease |
| title_short | Stereotactic body radiation therapy for the treatment of localized prostate cancer in men with underlying inflammatory bowel disease |
| title_sort | stereotactic body radiation therapy for the treatment of localized prostate cancer in men with underlying inflammatory bowel disease |
| topic | Prostate Stereotactic body radiation therapy Inflammatory bowel disease Ulcerative colitis Crohn’s disease |
| url | https://doi.org/10.1186/s13014-021-01850-1 |
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