Locally advanced prostatic cancer: long-term toxicity outcome after three-dimensional conformal radiation therapy--a dose-escalation study.

Abstract

Tumor dose escalation beyond conventional radiation doses for localized prostatic cancer is feasible when delivered with three-dimensional conformal radiation therapy, with no increase in morbidity in normal tissue.

Radiotherapy Treatment of Early-Stage Prostate Cancer with IMRT and Protons: A Treatment Planning Comparison

“…By employing advanced inverse treatment planning techniques, IMRT allowed for improvement in the dose distribution conformity to the tumor volume, and, consequently, a reduction in irradiation of the healthy surrounding tissue. While the dosimetric advantage of IMRT over the standard 3D-conformal photon therapy has been widely reported (7)(8)(9)(10)(11), a comprehensive planning comparison of IMRT and proton radiation therapy has not been performed thus far.…”

Direct Segment Aperture and Weight Optimization for Intensity-Modulated Radiotherapy of Prostate Cancer

“…There is strong evidence that both rectal dose and volume of rectum included in the high-dose region are the major determinants [13,17,19,22,25,26,29,33]. SOWAT generated a decrease in R vol50 , R vol60 , and R vol65 .…”

“…With regard to prostate cancer, the goal was to escalate the dose to both clinical target volume (CTV) and the part of the planning target volume (PTV) that does not overlap organs at risk (OARs) such as rectum, sigmoid colon or small bowel. Sufficient literature exists that such dose escalation improves local control and is possible without increased radiation toxicity [10,12,21,22,27,30,33]. Better local control also improves distant metastasis-free survival [5,14,19,22].…”

A Prospective Three–Dimensional Analysis about the Impact of Differences in the Clinical Target Volume in Prostate Cancer Irradiation on Normal–Tissue Exposure

“…It is not known whether the differences in radiation exposure between the different CTVs would be comparable to the differences shown in our study in case of an empty or filled bladder. The incidence of acute bladder toxicity increased when > 30% of the bladder received > 65 Gy [33,48]. Late complications like bladder contracture and volume loss are described in 5-10% at doses of 40 Gy delivered to the majority of the bladder, at doses of 50-65 Gy delivered to about 30% of the bladder volume, and at doses of 65-75 Gy applied to < 20% of the bladder volume [32].…”