Objekt-Metadaten

Risk adapted dose-intensified postoperative radiation therapy in prostate cancer patients using a simultaneous integrated boost technique applied with helical Tomotherapy
Beck, Marcus ;  Wust, Peter ;  Barelkowski, Tomasz ;  Kaul, David ;  Thieme, Alexander-Henry ;  Wecker, Sascha ;  Wlodarczyk, Waldemar ;  Budach, Volker ;  Ghadjar, Pirus

HaupttitelRisk adapted dose-intensified postoperative radiation therapy in prostate cancer patients using a simultaneous integrated boost technique applied with helical Tomotherapy
AutorBeck, Marcus
AutorWust, Peter
AutorBarelkowski, Tomasz
AutorKaul, David
AutorThieme, Alexander-Henry
AutorWecker, Sascha
AutorWlodarczyk, Waldemar
AutorBudach, Volker
AutorGhadjar, Pirus
Seitenzahl10 S.
Freie SchlagwörterProstate cancer; Radiation therapy; Postoperative; Salvage; Boost; Dose intensified
DDC610 Medizin und Gesundheit
Auch erschienen inRadiation Oncology. - 12 (2017), Artikel Nr. 125
ZusammenfassungBackground

Postoperative adjuvant radiation therapy (ART) in T3 and R1 prostate cancer as well as salvage radiation therapy (SRT) in case of postoperative biochemical failure (BF) are established treatments. Dose-intensified postoperative radiation therapy (RT) schemes have shown superior biochemical control accompanied by increased toxicity rates. In our study we evaluate a novel risk adapted dose-intensified postoperative RT scheme.

Methods

A consecutive series of prostate cancer patients receiving postoperative RT after radical prostatectomy using helical Tomotherapy between 04/2012 and 04/2015 was analyzed retrospectively. RT was administered using a simultaneous integrated boost (SIB) to the area at risk (37 fractions of 1.9 Gy, total dose: 70.3 Gy) being defined based on histopathological findings (T3/R1 region) and in few cases according to additional diagnostic imaging. The whole prostate bed was treated with a dose of 66.6 Gy (37 fractions of 1.8 Gy). Primary endpoints were acute and late genitourinary (GU) and gastrointestinal (GI) toxicities. Secondary endpoints included patient reported outcome as assessed by the International Prostate Symptom Score (IPSS), the International Consultation on Incontinence questionnaire (ICIQ) and prostate cancer specific Quality of Life questionnaire QLQ-PR25, as well as rates of BF.

Results

A total of 69 patients were analyzed. Sixteen patients underwent ART and 53 patients SRT, respectively. The median follow-up was 20 months (range, 8–41 months). Seven (10.1%) and four (5.8%) patients experienced acute grade 2 GU and GI toxicity. Two patients (2.9%) had late grade 2 GU toxicity, whereas no late grade 2 GI nor any grade 3 acute or late GU or GI events were observed. When compared to the baseline IPSS scores (p = 1.0) and ICIQ scores (p = 0.87) were not significantly different at the end of follow-up. Patient reported Quality of life (QoL) showed also no significant difference. A total of seven patients (10.1%) experienced a biochemical recurrence with the 2-year biochemical progression-free survival (bPFS) being 91%.

Conclusions

Postoperative RT for prostate cancer patients with a risk adapted dose-intensified SIB using helical tomotherapy is feasible and associated with favorable acute and late GU and GI toxicity rates, no significant change of IPSS-, ICIQ scores and patient reported QoL and results in promising bPFS rates.
Dokumente
PDF-Datei von FUDOCS_document_000000028009
Falls Ihr Browser eine Datei nicht öffnen kann, die Datei zuerst herunterladen und dann öffnen.
 
Fachbereich/EinrichtungMedizinische Fakultät Charité - Universitätsmedizin Berlin
Erscheinungsjahr2017
Dokumententyp/-SammlungenWissenschaftlicher Artikel
SpracheEnglisch
RechteCreative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Anmerkungen des AutorsDer Artikel wurde in einer reinen Open-Access-Zeitschrift publiziert.
Erstellt am26.09.2017 - 05:32:28
Letzte Änderung26.09.2017 - 05:33:11
 
Statische URLhttp://edocs.fu-berlin.de/docs/receive/FUDOCS_document_000000028009
DOI10.1186/s13014-017-0862-4
Zugriffsstatistik
 

LOADING...