Improved Clinical Outcomes With High-Dose Image Guided Radiotherapy Compared With Non-IGRT for the Treatment of Clinically Localized Prostate Cancer

Therapeutic outcomes of neoadjuvant and concurrent androgen‐deprivation therapy and intensity‐modulated radiation therapy with gold marker implantation for intermediate‐risk and high‐risk prostate cancer

“…The use of long-term hormone therapy in combination with conventional doses (65-70 Gy) of external beam radiation therapy has been shown to contribute to improved therapeutic outcomes in patients with localized prostate cancer, particularly those at high risk, whereas short-term neoadjuvant hormone therapy is believed to contribute to improved therapeutic outcomes in patients at moderate risk. [17][18][19][20][21][22][23][24] However, the evidence for these indications is based on radiation doses of 65-70 Gy, and the value of ADT in combination with !76 Gy radiation doses remains unclear. Opinions on this point are divided, as some studies have found no association between ADT and therapeutic outcomes of !76 Gy IMRT, whereas others have reported improved DMFS.…”

“…16,17,29,30 Zelefsky et al compared the toxicity and outcomes of high-dose (86.4 Gy) radiotherapy delivered by IGRT with GM implantation versus non-IGRT. 17 The incidence of grade !2 GU toxicity was significantly lower in the IGRT group than in the non-IGRT group (10.4% vs 20%), and multivariate analysis showed that IGRT was associated with a decreased incidence of late GU toxicity. The incidence of GI toxicity was also lower in the IGRT group than in the non-IGRT group (1.0% vs 1.6%); however, this difference was not significant.…”

“…[10][11][12][13][14][15] Recently, a few studies have reported on the therapeutic outcomes of IGRT using intraprostatic gold fiducial markers in localized prostate cancer. 16,17 Zelefsky et al reported that IGRT is associated with improved biochemical tumor control among high-risk patients and a lower rate of late urinary toxicity compared with conventional IMRT. 17 The use of ADT in combination with radiotherapy has been shown to contribute to improved therapeutic outcomes in patients with localized prostate cancer.…”

“…16,17 Zelefsky et al reported that IGRT is associated with improved biochemical tumor control among high-risk patients and a lower rate of late urinary toxicity compared with conventional IMRT. 17 The use of ADT in combination with radiotherapy has been shown to contribute to improved therapeutic outcomes in patients with localized prostate cancer. [18][19][20][21][22][23][24][25] According to the NCCN guidelines for prostate cancer risk, long-term ADT lasting 2-3 years is indicated for patients at high risk, whereas short-term ADT lasting 4-6 months can be considered for those at intermediate risk.…”

Optimizing the target detectability of cone beam CT performed in image‐guided radiation therapy for patients of different body sizes

“…To achieve high‐precision treatments, imaging plays a crucial role in planning and delivering radiation beams 6, 7. It has been demonstrated that the use of image‐guided radiation therapy (IGRT) may improve the clinical outcome of patients undergoing radiation therapy 8, 9. In our department, patients are routinely scanned by multidetector computed tomography (MDCT) scanners for planning purposes before treatment.…”