2008
DOI: 10.1016/j.ijrobp.2007.10.041
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Dose Escalation for Prostate Cancer Using the Three-Dimensional Conformal Dynamic Arc Technique: Analysis of 542 Consecutive Patients

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Cited by 32 publications
(20 citation statements)
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“…In order to limit the amount of severe side effects, some dose-escalation trials include dose-volume constraints in particular for the rectum/rectal wall [16,34]. Fiorino et al recommended dose-volume constraints for the rectum of < 55% to receive 50 Gy, < 40% to receive 60 Gy, < 25% to receive 70 Gy, and < 5% to receive 75 Gy.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…In order to limit the amount of severe side effects, some dose-escalation trials include dose-volume constraints in particular for the rectum/rectal wall [16,34]. Fiorino et al recommended dose-volume constraints for the rectum of < 55% to receive 50 Gy, < 40% to receive 60 Gy, < 25% to receive 70 Gy, and < 5% to receive 75 Gy.…”
Section: Discussionmentioning
confidence: 99%
“…Since 1996, multiple prospective studies have been performed revealing a dose response [2,[21][22][23]35] which resulted in a change of clinical practice by applying doses of 70-78 Gy during the last decade. Furthermore, new technologies, such as computerized treatment plan optimization, intensity-modulated radiotherapy (IMRT) and, most recently, image-guided radiotherapy (IGRT), have offered new possibilities for dose escalation [5, 6, 9, 11-13, 17, 19, 28, 31] enabling dose levels of ≥ 80 Gy [16,30,34]. Such doses are, in general, limited to prospective clinical studies performed by highly specialized radiotherapy centers, whereas in widespread daily clinical practice local doses so far applied range between 70-80 Gy.…”
Section: Introductionmentioning
confidence: 99%
“…The details of the treatment technique were already described previously [5,13,14]. In brief, our standard treatment consists of three-dimensional (3D) conformal two-dynamic arc therapy: two lateral arcs 100° wide are employed.…”
Section: Treatment Technique and Planningmentioning
confidence: 99%
“…Although in general antiandrogen monotherapy is thought to be inferior and less well tolerated that traditional androgen deprivation, 22 the study did suggest some benefit in higher-risk patients with locally advanced or micro-metastatic disease in progression-free survival, but there was no benefit in overall survival. 23 Similarly, although earlier studies might have suggested some benefit for neoadjuvant androgen deprivation prior to external beam radiation for low-risk patients, with higher dosing, 24 conformal techniques that appear to make doses of 70 to 79 Gy possible with minimal toxicity, 25 and the wider availability of brachytherapy, translate that, in general, neoadjuvant androgen deprivation is no longer recommended prior to radiation therapy for patients with low-risk prostate cancer. 26,27 In fact, the results of a large retrospective trial recently published in JAMA evaluated 19,271 with localized prostate cancer.…”
Section: Androgen Therapy Not Recommendedmentioning
confidence: 99%
“…16,17 A recent prospective controlled study of men on androgen deprivation more than 6 months found a decline of lower body physical function with statistically slower walk and chair-rise times with treatment. 18 A retrospective study from the Mayo Clinic in Scottsdale found that the average hemoglobin Localized dz -prior to eBXRT, brachy tx [24][25][26][27] Local/advanced dz -prior to eBXRT [43][44][45][46][47] Localized dz -no primary treatment 28 Local obstructive sx/metastatic disease 52 Biochemical recurrence after tx, slow PSADT 34 Biochem recurrence p tx, high-risk Cap death [36][37][38] Lymph node involvement at prostatectomy Goserelin acetate for prostate cancer Dovepress submit your manuscript | www.dovepress.com Dovepress drop on patients treated with LHRH antagonists is 1.6 g/dL which may contribute to the physical decline seen in these patients. 19 As previous studies have found a profound and prolonged suppression of testosterone long after the cessation of LHRH analogues (53% of men remaining castrate up to 2.5 years who had been on ADT for 4 or more years), 20 there is concern that the adverse risks of coronary artery disease, diabetes, osteoporosis, cognitive/physical changes, and anemia could persist beyond active therapy as well.…”
Section: Introductionmentioning
confidence: 99%