Radiation Oncology Journal

  • 제34권1호
  • /
  • Pages.45-51
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  • 2016
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  • 2234-1900(pISSN)
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  • 2234-3156(eISSN)
대한방사선종양학회 (The Korean Society for Radiation Oncology)
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Hypofractionated intensity-modulated radiotherapy in patients with localized prostate cancer: a preliminary study

  • Kang, Hye Jin (Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kay, Chul-Seung (Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Son, Seok Hyun (Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Myungsoo (Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Jo, In Young (Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, So Jung (Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, Dong Hwan (Department of Urology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Suh, Hong Jin (Department of Urology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Choi, Yong Sun (Department of Urology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine)
  • 투고 : 2015.09.08
  • 심사 : 2016.03.10
  • 발행 : 2016.03.31
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초록

Purpose: The aim of this work was to assess the efficacy and tolerability of hypofractionated intensity-modulated radiotherapy (IMRT) in patients with localized prostate cancer. Materials and Methods: Thirty-nine patients who received radical hypofractionated IMRT were retrospectively reviewed. Based on a pelvic lymph node involvement risk of 15% as the cutoff value, we decided whether to deliver treatment prostate and seminal vesicle only radiotherapy (PORT) or whole pelvis radiotherapy (WPRT). Sixteen patients (41%) received PORT with prostate receiving 45 Gy in 4.5 Gy per fraction in 2 weeks and the other 23 patients (59%) received WPRT with the prostate receiving 72 Gy in 2.4 Gy per fraction in 6 weeks. The median equivalent dose in 2 Gy fractions to the prostate was 79.9 Gy based on the assumption that the ${\alpha}/{\beta}$ ratio is 1.5 Gy. Results: The median follow-up time was 38 months (range, 4 to 101 months). The 3-year biochemical failure-free survival rate was 88.2%. The 3-year clinical failure-free and overall survival rates were 94.5% and 96.3%, respectively. The rates of grade 2 acute genitourinary (GU) and gastrointestinal (GI) toxicities were 20.5% and 12.8%, respectively. None of the patients experienced grade ${\geq}3$ acute GU and GI toxicities. The grade 2-3 late GU and GI toxicities were found in 8.1% and 5.4% of patients, respectively. No fatal late toxicity was observed. Conclusion: Favorable biochemical control with low rates of toxicity was observed after hypofractionated IMRT, suggesting that our radiotherapy schedule can be an effective treatment option in the treatment of localized prostate cancer.

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참고문헌

  1. World Cancer Research Fund International. Worldwide data: world cancer statistics for the most common cancers [Internet]. London: World Cancer Research Fund International; c2015 [cited 2015 Aug 12]. Available from: http://www.wcrf.org/int/cancer-facts-figures/worldwide-data.
  2. Jung KW, Won YJ, Kong HJ, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat 2015;47:127-41. https://doi.org/10.4143/crt.2015.060
  3. Zietman AL, DeSilvio ML, Slater JD, et al. Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. JAMA 2005;294:1233-9. https://doi.org/10.1001/jama.294.10.1233
  4. Peeters ST, Heemsbergen WD, Koper PC, et al. Dose-response in radiotherapy for localized prostate cancer: results of the Dutch multicenter randomized phase III trial comparing 68 Gy of radiotherapy with 78 Gy. J Clin Oncol 2006;24:1990-6. https://doi.org/10.1200/JCO.2005.05.2530
  5. Dearnaley DP, Jovic G, Syndikus I, et al. Escalated-dose versus control-dose conformal radiotherapy for prostate cancer: long-term results from the MRC RT01 randomised controlled trial. Lancet Oncol 2014;15:464-73. https://doi.org/10.1016/S1470-2045(14)70040-3
  6. Kuban DA, Tucker SL, Dong L, et al. Long-term results of the M. D. Anderson randomized dose-escalation trial for prostate cancer. Int J Radiat Oncol Biol Phys 2008;70:67-74. https://doi.org/10.1016/j.ijrobp.2007.06.054
  7. Eade TN, Hanlon AL, Horwitz EM, Buyyounouski MK, Hanks GE, Pollack A. What dose of external-beam radiation is high enough for prostate cancer? Int J Radiat Oncol Biol Phys 2007;68:682-9. https://doi.org/10.1016/j.ijrobp.2007.01.008
  8. Ray KJ, Sibson NR, Kiltie AE. Treatment of breast and prostate cancer by hypofractionated radiotherapy: potential risks and benefits. Clin Oncol (R Coll Radiol) 2015;27:420-6. https://doi.org/10.1016/j.clon.2015.02.008
  9. Tucker SL, Thames HD, Michalski JM, et al. Estimation of alpha/beta for late rectal toxicity based on RTOG 94-06. Int J Radiat Oncol Biol Phys 2011;81:600-5. https://doi.org/10.1016/j.ijrobp.2010.11.080
  10. Miralbell R, Roberts SA, Zubizarreta E, Hendry JH. Dosefractionation sensitivity of prostate cancer deduced from radiotherapy outcomes of 5,969 patients in seven international institutional datasets: ${\alpha}/{\beta}$ = 1.4 (0.9-2.2) Gy. Int J Radiat Oncol Biol Phys 2012;82:e17-24. https://doi.org/10.1016/j.ijrobp.2010.10.075
  11. Proust-Lima C, Taylor JM, Secher S, et al. Confirmation of a low ${\alpha}/{\beta}$ ratio for prostate cancer treated by external beam radiation therapy alone using a post-treatment repeatedmeasures model for PSA dynamics. Int J Radiat Oncol Biol Phys 2011;79:195-201. https://doi.org/10.1016/j.ijrobp.2009.10.008
  12. Dolezel M, Odrazka K, Zouhar M, et al. Comparing morbidity and cancer control after 3D-conformal (70/74 Gy) and intensity modulated radiotherapy (78/82 Gy) for prostate cancer. Strahlenther Onkol 2015;191:338-46. https://doi.org/10.1007/s00066-014-0806-y
  13. Jani AB, Su A, Correa D, Gratzle J. Comparison of late gastrointestinal and genitourinary toxicity of prostate cancer patients undergoing intensity-modulated versus conventional radiotherapy using localized fields. Prostate Cancer Prostatic Dis 2007;10:82-6. https://doi.org/10.1038/sj.pcan.4500910
  14. National Comprehensive Cancer Network. NCCN guidelines for patients: prostate cancer [Internet]. Fort Washington, PA: National Comprehensive Cancer Network; c2016 [cited 2016 Mar 17]. Available from: http://www.nccn.org/patients/guidelines/prostate/files/assets/common/downloads/files/prostate.pdf.
  15. Arcangeli S, Strigari L, Gomellini S, et al. Updated results and patterns of failure in a randomized hypofractionation trial for high-risk prostate cancer. Int J Radiat Oncol Biol Phys 2012;84:1172-8. https://doi.org/10.1016/j.ijrobp.2012.02.049
  16. Arcangeli G, Saracino B, Gomellini S, et al. A prospective phase III randomized trial of hypofractionation versus conventional fractionation in patients with high-risk prostate cancer. Int J Radiat Oncol Biol Phys 2010;78:11-8. https://doi.org/10.1016/j.ijrobp.2009.07.1691
  17. Huang EH, Pollack A, Levy L, et al. Late rectal toxicity: dosevolume effects of conformal radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 2002;54:1314-21. https://doi.org/10.1016/S0360-3016(02)03742-2
  18. Yeoh E, Horowitz M, Russo A, et al. Effect of pelvic irradiation on gastrointestinal function: a prospective longitudinal study. Am J Med 1993;95:397-406. https://doi.org/10.1016/0002-9343(93)90309-D
  19. Guckenberger M, Lawrenz I, Flentje M. Moderately hypofractionated radiotherapy for localized prostate cancer: long-term outcome using IMRT and volumetric IGRT. Strahlenther Onkol 2014;190:48-53. https://doi.org/10.1007/s00066-013-0443-x
  20. Zelefsky MJ, Cowen D, Fuks Z, et al. Long term tolerance of high dose three-dimensional conformal radiotherapy in patients with localized prostate carcinoma. Cancer 1999;85:2460-8. https://doi.org/10.1002/(SICI)1097-0142(19990601)85:11<2460::AID-CNCR23>3.0.CO;2-N
  21. Zelefsky MJ, Levin EJ, Hunt M, et al. Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys 2008;70:1124-9. https://doi.org/10.1016/j.ijrobp.2007.11.044
  22. Teh BS, Mai WY, Augspurger ME, et al. Intensity modulated radiation therapy (IMRT) following prostatectomy: more favorable acute genitourinary toxicity profile compared to primary IMRT for prostate cancer. Int J Radiat Oncol Biol Phys 2001;49:465-72. https://doi.org/10.1016/S0360-3016(00)01474-7
  23. Zelefsky MJ, Chan H, Hunt M, Yamada Y, Shippy AM, Amols H. Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer. J Urol 2006;176(4 Pt 1):1415-9. https://doi.org/10.1016/j.juro.2006.06.002

피인용 문헌

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  2. Treatment plan comparison between Tri-Co-60 magnetic-resonance image-guided radiation therapy and volumetric modulated arc therapy for prostate cancer vol.8, pp.53, 2017, https://doi.org/10.18632/oncotarget.20039