Improved Toxicity Profile Following High-Dose Postprostatectomy Salvage Radiation Therapy With Intensity-Modulated Radiation Therapy

Goenka, Anuj; Magsanoc, Juan Martin; Pei, Xin; Schechter, Michael S.; Kollmeier, Marisa A.; Cox, Brett; Scardino, Peter T.; Eastham, James A.; Zeléfsky, Michael J.

doi:10.1016/j.eururo.2011.08.006

Cited by 124 publications

(97 citation statements)

References 25 publications

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“…The main conclusion was that IMRT was associated with a statistically significant and substantial decrease in delayed gastrointestinal toxicity, even at doses higher than 70Gy compared to doses of less than 70Gy using conformal radiotherapy (B). 35 Although there is no evidence from randomized trials that higher doses provide better controls as rescue or adjuvant therapy, there is indirect evidence supporting dose escalation in patients treated with prostatectomy, and the general concern of using doses >70Gy was partially relieved (B). 35 A publication presented results of the effectiveness of IMRT and conformal radiotherapy in the treatment of PCa after prostatectomy, analyzing data from the SEER database.…”

Section: Radiation After Prostatectomymentioning

confidence: 99%

“…35 Although there is no evidence from randomized trials that higher doses provide better controls as rescue or adjuvant therapy, there is indirect evidence supporting dose escalation in patients treated with prostatectomy, and the general concern of using doses >70Gy was partially relieved (B). 35 A publication presented results of the effectiveness of IMRT and conformal radiotherapy in the treatment of PCa after prostatectomy, analyzing data from the SEER database. The analysis involved 1,014 patients, of whom 457 received IMRT and 557 received conformal radiotherapy.…”

Section: Radiation After Prostatectomymentioning

confidence: 99%

“…In terms of delayed toxicity (5 years), occurrences were observed in 10.2% of patients undergoing conformal radiation therapy and in 1.9% of patients treated with IMRT (p=0.02) (B). 35 Rescue radiation therapy is offered to patients with high levels of PSA after radical prostatectomy. It is consensus that PSA levels considered as failure following radical surgery is in the range of 0.2-0.5 ng/mL.…”

Section: Radiation After Prostatectomymentioning

confidence: 99%

See 2 more Smart Citations

Treatment of prostate cancer with intensity modulated radiation therapy (IMRT)

Novaes¹,

Mottas²,

Lundgren³

2015

Rev. Assoc. Med. Bras.

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Section: Radiation After Prostatectomymentioning

confidence: 99%

Section: Radiation After Prostatectomymentioning

confidence: 99%

Section: Radiation After Prostatectomymentioning

confidence: 99%

See 1 more Smart Citation

Treatment of prostate cancer with intensity modulated radiation therapy (IMRT)

Novaes¹,

Mottas²,

Lundgren³

2015

Rev. Assoc. Med. Bras.

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“…RP sonrası RT uygulanan 959 hastanın (%19 adjuvan, %81 salvaj RT) retrospektif toksisite değerlendirmesinde geç derece 2 ve 3 üriner toksisite %10 ve %3, geç derece 2 ve 3 rektal toksisite %4 ve %0,3 oranlarında bildirilmiştir (32). RT'nin toksisitesi ve hayat kalitesi üzerine olan etkileri konusundaki kanıtlar eski RT tekniklerinin kullanıldığı çalışmalardan gelmekte olup yeni tekniklerin yan etki oranları daha düşüktür (33,34). Genitoüriner toksisite oranları gastrointestinal toksisiteden daha yüksektir, ancak IMRT gibi modern RT tekniklerinin kullanılmasıyla toksisite oranları azalmıştır (34).…”

Section: Radyoterapinin Yan Etkileriunclassified

“…RT'nin toksisitesi ve hayat kalitesi üzerine olan etkileri konusundaki kanıtlar eski RT tekniklerinin kullanıldığı çalışmalardan gelmekte olup yeni tekniklerin yan etki oranları daha düşüktür (33,34). Genitoüriner toksisite oranları gastrointestinal toksisiteden daha yüksektir, ancak IMRT gibi modern RT tekniklerinin kullanılmasıyla toksisite oranları azalmıştır (34). RT'nin adjuvan veya salvaj olarak uygulanmasının toksisitede fark yaratmadığı da geniş hasta serisi içeren güncel çalışmalarda gösterilmiştir (35,36).…”

Section: Radyoterapinin Yan Etkileriunclassified

AUA/ASTRO 2013 Guidelines for Adjuvant and Salvage Radiation Therapy After Prostatectomy: What are the Yields and the Changes?

Yaman¹

2015

uob

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Comparative Effectiveness of Intensity-Modulated Radiotherapy and Conventional Conformal Radiotherapy in the Treatment of Prostate Cancer After Radical Prostatectomy

Goldin¹,

Sheets²,

Meyer³

et al. 2013

JAMA Intern Med

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Importance: Comparative effectiveness research of prostate cancer therapies is needed because of the development and rapid clinical adoption of newer and costlier treatments without proven clinical benefit. Radiotherapy is indicated after prostatectomy in select patients who have adverse pathologic features and in those with recurrent disease.Objectives: To examine the patterns of use of intensitymodulated radiotherapy (IMRT), a newer, more expensive technology that may reduce radiation dose to adjacent organs compared with the older conformal radiotherapy (CRT) in the postprostatectomy setting, and to compare disease control and morbidity outcomes of these treatments.Design and Setting: Data from the Surveillance, Epidemiology, and End Results-Medicare-linked database were used to identify patients with a diagnosis of prostate cancer who had received radiotherapy within 3 years after prostatectomy.Participants: Patients who received IMRT or CRT. Main Outcomes and Measures:The outcomes of 457 IMRT and 557 CRT patients who received radiotherapy between 2002 and 2007 were compared using their claims through 2009. We used propensity score methods to balance baseline characteristics and estimate adjusted incidence rate ratios (RRs) and their 95% CIs for measured outcomes.Results: Use of IMRT increased from zero in 2000 to 82.1% in 2009. Men who received IMRT vs CRT showed no significant difference in rates of long-term gastrointestinal morbidity (RR, 0.95; 95% CI, 0.66-1.37), urinary nonincontinent morbidity (0.93; 0.66-1.33), urinary incontinence (0.98; 0.71-1.35), or erectile dysfunction (0.85; 0.61-1.19). There was no significant difference in subsequent treatment for recurrent disease (RR,1.31; 95% CI, 0.90-1.92).Conclusions and Relevance: Postprostatectomy IMRT and CRT achieved similar morbidity and cancer control outcomes. The potential clinical benefit of IMRT in this setting is unclear. Given that IMRT is more expensive, its use for postprostatectomy radiotherapy may not be cost-effective compared with CRT, although formal analysis is needed.

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Improved Toxicity Profile Following High-Dose Postprostatectomy Salvage Radiation Therapy With Intensity-Modulated Radiation Therapy

Cited by 124 publications

References 25 publications

Treatment of prostate cancer with intensity modulated radiation therapy (IMRT)

Treatment of prostate cancer with intensity modulated radiation therapy (IMRT)

AUA/ASTRO 2013 Guidelines for Adjuvant and Salvage Radiation Therapy After Prostatectomy: What are the Yields and the Changes?

Comparative Effectiveness of Intensity-Modulated Radiotherapy and Conventional Conformal Radiotherapy in the Treatment of Prostate Cancer After Radical Prostatectomy

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