Whole Pelvic Radiotherapy With Stereotactic Body Radiotherapy Boost vs. Conventionally Fractionated Radiotherapy for Patients With High or Very High-Risk Prostate Cancer
Background: Whole pelvic radiotherapy (WPRT) with stereotactic body radiotherapy (SBRT) boost has been shown to be effective in patients with high-risk prostate cancer (PC). However, no study has directly compared the efficacy of WPRT with SBRT boost with that of conventionally fractionated radiothe...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2020.00814/full |
| _version_ | 1818310691578183680 |
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| author | Shih-Chang Wang Wei-Chen Ting Yun-Ching Chang Ching-Chieh Yang Ching-Chieh Yang Li-Ching Lin Hsiu-Wen Ho Shou-Sheng Chu Yu-Wei Lin Yu-Wei Lin Yu-Wei Lin |
| author_facet | Shih-Chang Wang Wei-Chen Ting Yun-Ching Chang Ching-Chieh Yang Ching-Chieh Yang Li-Ching Lin Hsiu-Wen Ho Shou-Sheng Chu Yu-Wei Lin Yu-Wei Lin Yu-Wei Lin |
| author_sort | Shih-Chang Wang |
| collection | DOAJ |
| description | Background: Whole pelvic radiotherapy (WPRT) with stereotactic body radiotherapy (SBRT) boost has been shown to be effective in patients with high-risk prostate cancer (PC). However, no study has directly compared the efficacy of WPRT with SBRT boost with that of conventionally fractionated radiotherapy (CFRT). We compared the clinical outcomes between CFRT and WPRT with SBRT boost in patients with high or very high-risk PC (National Comprehensive Cancer Network definition).Methods: In total, 132 patients treated with CFRT and 121 patients treated with WPRT followed by SBRT boost were retrospectively analyzed. For the CFRT group, the prescribed dose range was 74–79.2 Gray (Gy) administered at 1.8–2 Gy per fraction. For WPRT with SBRT boost, the prescribed doses were 45 Gy administered in 25 fractions to the whole pelvis followed by 21 Gy boost (3 fractions of 7 Gy each) to prostate and seminal vesicles. The overall survival (OS) and biochemical failure (Phoenix definition) free survival (bFFS) were assessed by using the Kaplan–Meier method or the Cox proportional hazards regression model. The gastrointestinal (GI) and genitourinary (GU) tract toxicity were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) v3.0.Results: The estimated 4-years overall survival in the CFRT and WPRT with SBRT boost groups was 91.6 and 97.7%, respectively (P = 0.18). The estimated 4-years biochemical failure-free survival in the CFRT and WPRT with SBRT boost groups was 89.1 and 93.9%, respectively (P = 0.41). No acute grade 3 or higher GI and GU toxicity was observed in both groups. Late grade 3 GI and GU toxicity occurred in 2.3 and 2.3% in the CFRT group, and in 1.7 and 0.8% in the WPRT with SBRT boost group, respectively. There was no significant between-group difference with respect to acute or late toxicity.Conclusions: In patients with high or very high-risk localized PC, compared with CFRT, WPRT with SBRT boost resulted in similar biochemical-free and overall survival rate with minimal toxicity. WPRT with SBRT boost is a feasible option for patients with high or very high-risk PC. |
| first_indexed | 2024-12-13T07:50:05Z |
| format | Article |
| id | doaj.art-db0a46bf1a2a4708bcd0b64d3eb89c09 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-13T07:50:05Z |
| publishDate | 2020-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-db0a46bf1a2a4708bcd0b64d3eb89c092022-12-21T23:54:42ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-05-011010.3389/fonc.2020.00814524457Whole Pelvic Radiotherapy With Stereotactic Body Radiotherapy Boost vs. Conventionally Fractionated Radiotherapy for Patients With High or Very High-Risk Prostate CancerShih-Chang Wang0Wei-Chen Ting1Yun-Ching Chang2Ching-Chieh Yang3Ching-Chieh Yang4Li-Ching Lin5Hsiu-Wen Ho6Shou-Sheng Chu7Yu-Wei Lin8Yu-Wei Lin9Yu-Wei Lin10Department of Radiation Oncology, Chi Mei Medical Center, Tainan, TaiwanDepartment of Radiation Oncology, Antai Medical Care Corporation Antai Tian-Sheng Memorial Hospital, Pingtung, TaiwanDepartment of Nursing, Shu-Zen College of Medicine and Management, Kaohsiung, TaiwanDepartment of Radiation Oncology, Chi Mei Medical Center, Tainan, TaiwanDepartment of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, TaiwanDepartment of Radiation Oncology, Chi Mei Medical Center, Tainan, TaiwanDepartment of Radiation Oncology, Chi Mei Medical Center, Tainan, TaiwanDepartment of Radiation Oncology, Chi Mei Medical Center, Tainan, TaiwanDepartment of Radiation Oncology, Chi Mei Medical Center, Tainan, TaiwanDepartment of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, TaiwanInstitute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, TaiwanBackground: Whole pelvic radiotherapy (WPRT) with stereotactic body radiotherapy (SBRT) boost has been shown to be effective in patients with high-risk prostate cancer (PC). However, no study has directly compared the efficacy of WPRT with SBRT boost with that of conventionally fractionated radiotherapy (CFRT). We compared the clinical outcomes between CFRT and WPRT with SBRT boost in patients with high or very high-risk PC (National Comprehensive Cancer Network definition).Methods: In total, 132 patients treated with CFRT and 121 patients treated with WPRT followed by SBRT boost were retrospectively analyzed. For the CFRT group, the prescribed dose range was 74–79.2 Gray (Gy) administered at 1.8–2 Gy per fraction. For WPRT with SBRT boost, the prescribed doses were 45 Gy administered in 25 fractions to the whole pelvis followed by 21 Gy boost (3 fractions of 7 Gy each) to prostate and seminal vesicles. The overall survival (OS) and biochemical failure (Phoenix definition) free survival (bFFS) were assessed by using the Kaplan–Meier method or the Cox proportional hazards regression model. The gastrointestinal (GI) and genitourinary (GU) tract toxicity were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) v3.0.Results: The estimated 4-years overall survival in the CFRT and WPRT with SBRT boost groups was 91.6 and 97.7%, respectively (P = 0.18). The estimated 4-years biochemical failure-free survival in the CFRT and WPRT with SBRT boost groups was 89.1 and 93.9%, respectively (P = 0.41). No acute grade 3 or higher GI and GU toxicity was observed in both groups. Late grade 3 GI and GU toxicity occurred in 2.3 and 2.3% in the CFRT group, and in 1.7 and 0.8% in the WPRT with SBRT boost group, respectively. There was no significant between-group difference with respect to acute or late toxicity.Conclusions: In patients with high or very high-risk localized PC, compared with CFRT, WPRT with SBRT boost resulted in similar biochemical-free and overall survival rate with minimal toxicity. WPRT with SBRT boost is a feasible option for patients with high or very high-risk PC.https://www.frontiersin.org/article/10.3389/fonc.2020.00814/fullprostate cancerSBRTconventionally fractionatedhigh riskradiotherapy |
| spellingShingle | Shih-Chang Wang Wei-Chen Ting Yun-Ching Chang Ching-Chieh Yang Ching-Chieh Yang Li-Ching Lin Hsiu-Wen Ho Shou-Sheng Chu Yu-Wei Lin Yu-Wei Lin Yu-Wei Lin Whole Pelvic Radiotherapy With Stereotactic Body Radiotherapy Boost vs. Conventionally Fractionated Radiotherapy for Patients With High or Very High-Risk Prostate Cancer Frontiers in Oncology prostate cancer SBRT conventionally fractionated high risk radiotherapy |
| title | Whole Pelvic Radiotherapy With Stereotactic Body Radiotherapy Boost vs. Conventionally Fractionated Radiotherapy for Patients With High or Very High-Risk Prostate Cancer |
| title_full | Whole Pelvic Radiotherapy With Stereotactic Body Radiotherapy Boost vs. Conventionally Fractionated Radiotherapy for Patients With High or Very High-Risk Prostate Cancer |
| title_fullStr | Whole Pelvic Radiotherapy With Stereotactic Body Radiotherapy Boost vs. Conventionally Fractionated Radiotherapy for Patients With High or Very High-Risk Prostate Cancer |
| title_full_unstemmed | Whole Pelvic Radiotherapy With Stereotactic Body Radiotherapy Boost vs. Conventionally Fractionated Radiotherapy for Patients With High or Very High-Risk Prostate Cancer |
| title_short | Whole Pelvic Radiotherapy With Stereotactic Body Radiotherapy Boost vs. Conventionally Fractionated Radiotherapy for Patients With High or Very High-Risk Prostate Cancer |
| title_sort | whole pelvic radiotherapy with stereotactic body radiotherapy boost vs conventionally fractionated radiotherapy for patients with high or very high risk prostate cancer |
| topic | prostate cancer SBRT conventionally fractionated high risk radiotherapy |
| url | https://www.frontiersin.org/article/10.3389/fonc.2020.00814/full |
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