Potential interest of developing an integrated boost dose escalation for stereotactic irradiation of primary prostate cancer

Udrescu, C.; Rouvière, Olivier; Enachescu, C.; Sotton, M.-P.; Bouffard-Vercelli, J.; Jalade, P.; Chapet, O.

doi:10.1016/j.ejmp.2013.09.005

Cited by 6 publications

(3 citation statements)

References 36 publications

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“…For plans that involved higher doses prescribed to the boost volume and lower doses prescribed to the rest of the prostate volume, similar or not significantly different doses to OARs were generally reported [12,45,65,68,76,77,123]. For instance, compared with a treatment with the whole-gland dose of 40 Gy in five fractions (homogenous dose escalation to the entire gland), significantly improved protection of the bladder and rectum was reported with focal boost plans that de-escalated the dose to the prostate (35.2 Gy to prostate PTV with 40 Gy to PTV boost in five fractions) [70].…”

Section: Dosimetric Outcomesmentioning

confidence: 61%

“…The longest reported follow-up time was 124 months [49]. In the planning studies, as shown in Table 2, the majority of studies utilized mpMRI for GTV delineation [10,18,45,[57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75]. Five studies utilized PET-CT [12,[76][77][78][79][80], and four studies used "other methods" such as histopathology data or hypothetical IPLs [81][82][83][84].…”

Section: Statistics Of Reviewed Studiesmentioning

confidence: 99%

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Focal Boost in Prostate Cancer Radiotherapy: A Review of Planning Studies and Clinical Trials

Zhao,

Haworth,

Rowshanfarzad

et al. 2023

Cancers

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Background: Focal boost radiotherapy was developed to deliver elevated doses to functional sub-volumes within a target. Such a technique was hypothesized to improve treatment outcomes without increasing toxicity in prostate cancer treatment. Purpose: To summarize and evaluate the efficacy and variability of focal boost radiotherapy by reviewing focal boost planning studies and clinical trials that have been published in the last ten years. Methods: Published reports of focal boost radiotherapy, that specifically incorporate dose escalation to intra-prostatic lesions (IPLs), were reviewed and summarized. Correlations between acute/late ≥G2 genitourinary (GU) or gastrointestinal (GI) toxicity and clinical factors were determined by a meta-analysis. Results: By reviewing and summarizing 34 planning studies and 35 trials, a significant dose escalation to the GTV and thus higher tumor control of focal boost radiotherapy were reported consistently by all reviewed studies. Reviewed trials reported a not significant difference in toxicity between focal boost and conventional radiotherapy. Acute ≥G2 GU and late ≥G2 GI toxicities were reported the most and least prevalent, respectively, and a negative correlation was found between the rate of toxicity and proportion of low-risk or intermediate-risk patients in the cohort. Conclusion: Focal boost prostate cancer radiotherapy has the potential to be a new standard of care.

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Section: Dosimetric Outcomesmentioning

confidence: 61%

Section: Statistics Of Reviewed Studiesmentioning

confidence: 99%

Focal Boost in Prostate Cancer Radiotherapy: A Review of Planning Studies and Clinical Trials

Zhao,

Haworth,

Rowshanfarzad

et al. 2023

Cancers

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“…Given that the majority of local relapses occur at the site of primary tumor following radiotherapy for prostate cancer ( 54 , 55 ), and to minimize the QOL decrements associated with whole gland boost, the next step would be dose painting with focal boost to the dominant nodule. A planning study by Udrescu et al, demonstrated a significant improvement in the bladder and rectal dosimetry in the MRI based focal boost plan when compared to the whole gland boost ( 56 ). In the study by Aluwini et al, 50 low- and intermediate-risk prostate cancer patients were treated with SABR to a total dose of 38 Gy delivered in four daily fractions and an integrated boost of up to 11 Gy per fraction was applied to the dominant lesion visible on MRI.…”

Section: Discussionmentioning

confidence: 99%

Evolution of Hypofractionated Accelerated Radiotherapy for Prostate Cancer â€“ The Sunnybrook Experience

2014

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Stereotactic ablative body radiotherapy (SABR) is a newer method of ultra hypo fractionated radiotherapy that uses combination of image-guided radiotherapy (IGRT) and intensity-modulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT), to deliver high doses of radiation in a few fractions to a target, at the same time sparing the surrounding organs at risk (OAR). SABR is ideal for treating small volumes of disease and has been introduced in a number of disease sites including brain, lung, liver, spine, and prostate. Given the radiobiological advantages of treating prostate cancer with high doses per fraction, SABR is becoming a standard of care for low and intermediate-risk prostate cancer patients based upon the results from Sunnybrook and also the US-based prostate SABR consortium. This review examines the development of moderate and ultra hypo-fractionation schedules at the Odette Cancer centre, Sunnybrook Health Sciences. Moderate hypo-fractionation protocol was first developed in 2001 for intermediate-risk prostate cancer and from there on different treatment schedules including SABR evolved for all risk groups.

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Treatment plan comparison between stereotactic body radiation therapy techniques for prostate cancer: Non-isocentric CyberKnife versus isocentric RapidArc

Lin

et al. 2014

Physica Medica

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Potential interest of developing an integrated boost dose escalation for stereotactic irradiation of primary prostate cancer

Cited by 6 publications

References 36 publications

Focal Boost in Prostate Cancer Radiotherapy: A Review of Planning Studies and Clinical Trials

Focal Boost in Prostate Cancer Radiotherapy: A Review of Planning Studies and Clinical Trials

Evolution of Hypofractionated Accelerated Radiotherapy for Prostate Cancer â€“ The Sunnybrook Experience

Treatment plan comparison between stereotactic body radiation therapy techniques for prostate cancer: Non-isocentric CyberKnife versus isocentric RapidArc

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