Three Years of Salvage IMRT for Prostate Cancer: Results of the Montpellier Cancer Center

Riou, O.; Fenoglietto, P.; Laliberté, Benoit; Menkarios, C.; Moscardo, C. Llacer; Hay, M.; Aillères, N.; Dubois, Jean‐Bernard; Rébillard, Xavier; Azria, D.

doi:10.5402/2012/391705

Cited by 3 publications

(3 citation statements)

References 58 publications

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“…A few retrospective studies have investigated the use of IMRT for post-prostatectomy radiotherapy. 27 , 89 , 90 Bastasch et al 91 reported the effects on erectile function of dose-escalated prostate bed IMRT in a retrospective series. Despite the high dose (mean 69.6 Gy) to the prostate bed, this had no negative effect on erectile function for the patients who remained potent after nerve-sparing prostatectomy; the follow-up in this group was 19.5 months.…”

Section: Radiotherapy Dose and Toxicitymentioning

confidence: 99%

Rationale and development of image-guided intensity-modulated radiotherapy post-prostatectomy: the present standard of care?

Murray

McNair

Dearnaley

2015

CMAR

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The indications for post-prostatectomy radiotherapy have evolved over the last decade, although the optimal timing, dose, and target volume remain to be well defined. The target volume is susceptible to anatomical variations with its borders interfacing with the rectum and bladder. Image-guided intensity-modulated radiotherapy has become the gold standard for radical prostate radiotherapy. Here we review the current evidence for image-guided techniques with intensity-modulated radiotherapy to the prostate bed and describe current strategies to reduce or account for interfraction and intrafraction motion.

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Section: Radiotherapy Dose and Toxicitymentioning

confidence: 99%

Rationale and development of image-guided intensity-modulated radiotherapy post-prostatectomy: the present standard of care?

Murray

McNair

Dearnaley

2015

CMAR

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“… 11 Intensity-modulated radiotherapy (IMRT) for PLNs enhances treatment dose conformity and enables dose escalation to the clinical target volume (CTV) while decreasing dose to the surrounding organs at risk (OAR), resulting in increase of the therapeutic ratio. 12 – 14 Volumetric modulated arc therapy (VMAT) is a further evolution of IMRT, which may enable more efficient radiation treatment. 15 …”

Section: Introductionmentioning

confidence: 99%

Clinical outcome and toxicity evaluation of simultaneous integrated boost pelvic IMRT/VMAT at different dose levels combined with androgen deprivation therapy in prostate cancer patients

Daoud

Aboelnaga

Alashry

et al. 2017

OTT

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BackgroundThe role of dose escalation in patients receiving long-term androgen deprivation therapy (ADT) is still a controversial issue. The aim of the current study was to evaluate whether dose escalation for ≥76–80 Gy had any advantage in terms of biochemical disease-free survival (BDFS), distant metastasis-free survival (DMFS), or overall survival outcomes over the dose levels from 70 to <76 Gy.Patients and methodsThe study included a cohort of 24 patients classified with high- and intermediate-risk localized prostate cancer. All patients received ADT, starting at 4–6 months before radiation therapy and continued for a total period of 12–24 months in high-risk patients. The treatment plan was given in two phases. In the first phase, the nodal planning target volume (PTV) and the prostate PTV received 48.6 and 54 Gy, respectively, over 27 fractions. The treatment was applied through intensity-modulated radiation therapy or volumetric modulated arc therapy with a simultaneous integrated boost technique.ResultsMore than half of the patients were in T3–T4 stage, 79.1% of the patients were in the high-risk category, and all patients received ADT. The rate of acute grade II gastrointestinal and genitourinary toxicities in all patients were 41.7% and 62.5%, respectively. The rate of freedom from grade II rectal toxicity at 2 years was 89% and 83% for patients treated with dose levels <76 and ≥76 Gy, respectively. The rate of BDFS at 2 years was 90% and 85% for doses <76 and ≥76 Gy, respectively. The DMFS at 2 years was 100% and 76% for dose levels <76 and ≥76 Gy, respectively.ConclusionIn the current study, there were no significant differences in the BDFS and DMFS between patients treated with a dose of <76 and ≥76 Gy, including elective pelvic lymph nodes irradiation combined with ADT.

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“…Intensity modulated radiotherapy (IMRT) enhances treatment dose conformality [ 9 ]. This enables dose escalation to the clinical target volume whilst decreasing dose to surrounding normal tissue, thereby increasing the therapeutic ratio [ 9 – 11 ]. Volumetric modulated arc therapy (VMAT) has been shown in the Australian context to be superior to 3D conformal radiotherapy (3D-CRT) and step and shoot IMRT in terms of dose-volume histogram coverage of planning target volumes (PTVs) and organs at risk (OARs) [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Volumetric Modulated Arc Therapy of the Pelvic Lymph Nodes to the Aortic Bifurcation in Higher Risk Prostate Cancer: Early Toxicity Outcomes

Hesselberg

Fogarty

Haydu

et al. 2015

BioMed Research International

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Background. Treatment of pelvic lymph nodes (PLNs) in higher risk prostate carcinoma is controversial. The primary focus of the study was to evaluate the early toxicity profile for this cohort of patients treated with Volumetric Modulated Arc Therapy (VMAT). Methods. Patient, tumour, and treatment characteristics of those who received VMAT from May 2010 to December 2012 were analysed. A simplified contouring process of the PLNs to the aortic bifurcation was developed based on consensus guidelines. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities were documented according to the Radiation Therapy Oncology Group (RTOG) Version 2 Guidelines. Successive Prostate Specific Antigen (PSA) values after treatment were measured on average 3 months apart. Results. 113 patients were treated between May 2010 to December 2012 with a median follow-up of 14 months. No patients experienced acute grade 3 or 4 GU and GI toxicity. Only 1 patient experienced a late grade 3 GU complication. No late grade 4 GU or GI events have yet occurred. Conclusions. This study reviews the first Australian experience of VMAT in the treatment of pelvic lymph nodes in prostate cancer, specifically to the level of the aortic bifurcation. It demonstrates a favorable acute toxicity profile whilst treating large PLN volumes with optimal dose coverage.

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Three Years of Salvage IMRT for Prostate Cancer: Results of the Montpellier Cancer Center

Cited by 3 publications

References 58 publications

Rationale and development of image-guided intensity-modulated radiotherapy post-prostatectomy: the present standard of care?

Rationale and development of image-guided intensity-modulated radiotherapy post-prostatectomy: the present standard of care?

Clinical outcome and toxicity evaluation of simultaneous integrated boost pelvic IMRT/VMAT at different dose levels combined with androgen deprivation therapy in prostate cancer patients

Volumetric Modulated Arc Therapy of the Pelvic Lymph Nodes to the Aortic Bifurcation in Higher Risk Prostate Cancer: Early Toxicity Outcomes

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