High-dose intensity modulated radiation therapy for prostate cancer: early toxicity and biochemical outcome in 772 patients

Zeléfsky, Michael J.; Fuks, Zvi; Hunt, Margie; Yamada, Yoshiya; Marion, C; Ling, C. Clifton; Amols, H; Venkatraman, Ennapadam; Leibel, Steven A.

doi:10.1016/s0360-3016(02)02857-2

Cited by 708 publications

(219 citation statements)

References 21 publications

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“…In addition, compared with other pelvic organs, bladder is more tolerance irradiated organs and the TD 5/5 for whole and 2/3 volume irradiation were 65 Gy and 80 Gy, respectively [22]. Studies have shown that the incidence of Grade 3/4 bladder toxicity was only 1% to 2% [10] [23]. 5F-IMRT and VMAT showed a clear advantage in terms of femoral heads sparing at D mean and V 30 with respect to 3D-CRT, which may reduce the probability of occurrence of avascular necrosis.…”

Section: Discussionmentioning

confidence: 99%

Dosimetric Comparison of Volumetric Modulated Arc Therapy (VMAT), 5F Intensity Modulated Radiotherapy (IMRT) and 3D Conformal Radiotherapy (3DCRT) in Rectal Carcinoma Receiving Neoadjuvant Chemoradiotherapy

Wen¹,

Zhang²,

Chi³

et al. 2015

IJMPCERO

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Objective: To investigate better dosimetric distribution of volumetric modulated arc therapy (VMAT) vs. 5F intensity modulated radiotherapy (IMRT) and 3D conformal radiotherapy (3DCRT) in patients with locally advanced rectal cancer (LARC) when treated with neoadjuvant chemoradiotherapy. Methods: 3D-CRT, 5F-IMRT and VMAT plans for preoperative radiotherapy were designed in 12 patients with locally advanced rectal cancer. The conformity index (CI) and homogeneity index (HI) in target volume, and the dose and volume of the organs at risk (OAR) irradiated including small bowel, bladder and bilatera1 femoral heads were compared among the three plans. Results: The CI for planning target volume (PTV) 2 and HI for PTV1 of VMRT and 5F-IMRT were superior to 3D-CRT. The CI of VMAT, 5F-IMRT and 3D-CRT plans were 0.71, 0.69 and 0.62 (p = 0.011 and p = 0.019, respectively). The HI of the VMAT and 5F-IMRT plans were both 1.04 and 3D-CRT planning was 1.06 (p = 0.022 and p = 0.006, respectively). The V35 -V45 of small bowel * Corresponding authors. G. Wen et al. 55in VMAT were significantly less than in 5F-IMRT and 3D-CRT. V35 was 47.0, 56.4, and 72.8 cm 3 for VMAT, 5F-IMRT, and 3D-CRT (p = 0.021 and p = 0.034, respectively), while V40 was 30.5, 35.5, 45.1 cm 3 (p = 0.024 and p = 0.032, respectively) and V45 was 15.1, 18.1, 30.0 cm 3 (p = 0.033 and p = 0.032, respectively). The D5, V30 and V50 of bladder in 3D-CRT were less than in VMAT and 5F-IMRT planning (p = 0.034, 0.004, 0.002 and p = 0.027, 0.003, 0.002, respectively). The Dmean of left femoral head in VMAT and 5F-IMRT were less than in 3D-CRT planning (p = 0.028 and p = 0.022, respectively) and the Dmean, V30 of right femoral head in VMAT and 5F-IMRT were better than in 3D-CRT planning (p = 0.044, 0.036 and p = 0.023, 0.028, respectively). Conclusions: Dosimetric analyses demonstrated that IMRT is superior to 3D-CRT in the conformity and homogeneity of dose distribution to the target volume, and provide a better protection to OARs sparing in patients with locally advanced rectal cancer for preoperative radiotherapy. With similar target coverage, VMRT is superior to 5F-IMRT in normal tissue sparing.

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Section: Discussionmentioning

confidence: 99%

Dosimetric Comparison of Volumetric Modulated Arc Therapy (VMAT), 5F Intensity Modulated Radiotherapy (IMRT) and 3D Conformal Radiotherapy (3DCRT) in Rectal Carcinoma Receiving Neoadjuvant Chemoradiotherapy

Wen¹,

Zhang²,

Chi³

et al. 2015

IJMPCERO

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“…The effectivity of a h pecially for patients with an intermediate and high risk profile [5,6,8]. The biochemical cure rates seem to be roughly comparable at least for the stages T1-T2 between conformation irradiation (min.…”

Section: Discussionmentioning

confidence: 97%

“…Based on this clinical study there appear to be grounds for suspicion that the different trend in the above mentioned items in the intra and acute postactinic phase is resulting from a mechanical irritation due to the daily application of the rectum balloon. The fundamental idea of the rectum bal loon with dose-volume calculations is a concept to be taken into account considering economical aspects; future-oriented therapy options such as the combination of percutaneous and interstitial radiation and the wider use of IMRT could generate unquestionably a reasonable advantage for the patients concerning the reduction of radiation-induced toxicities [8,39,40].…”

Section: Discussionmentioning

confidence: 99%

Can the Rectum Balloon Minimize Rectal Toxicity During Irradiation Therapy of Prostate Cancer?

Landwehr¹,

Krukemeyer²,

Wagner³

2013

OJU

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The irradiation of the rectum cancer occurs in many institutes by using a rectum balloon in order to reduce the mobility of the target organ and to distance the rectum from the target organ. The objective is to reduce side effects quantitatively as well as qualitatively. On the basis of two hospitals using identical techniques for the prostate irradiation with the sole difference of the rectum balloon the toxicity has been evaluated with the result of no significant difference between the cohorts concerning diarrhea, rectal pain symptoms and rectal bleedings. Therefore the authors consider the use of the rectum balloon prior to each irradiation not necessary for the reduction of toxicity particularly due to the fact that the application is often very painful, especially for patients with hemorrhoids. The rectum balloon as a tool for the reduction of the prostate mobility was not objective of this study.

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“…For example, a large IMRT-based prostate cancer dose-escalation study initiated at the Memorial Sloan-Kettering Cancer Center although not randomized reported a favorable toxicity profile in patients treated with IMRT as compared to those who had received 3D treatment, despite a further increase in the prescribed total dose [35,36]. In principle, dose escalation can be achieved either by increasing the number of fractions at 1.8-2 Gy per fraction or by increasing the dose per fraction above 2 Gy (hypofractionation).…”

Section: Dose-escalated Simultaneous Integrated-boost Treatment Of Prmentioning

confidence: 99%

Dose-escalated simultaneous integrated-boost treatment of prostate cancer patients via helical tomotherapy

et al. 2012

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High-dose intensity modulated radiation therapy for prostate cancer: early toxicity and biochemical outcome in 772 patients

Cited by 708 publications

References 21 publications

Dosimetric Comparison of Volumetric Modulated Arc Therapy (VMAT), 5F Intensity Modulated Radiotherapy (IMRT) and 3D Conformal Radiotherapy (3DCRT) in Rectal Carcinoma Receiving Neoadjuvant Chemoradiotherapy

Dosimetric Comparison of Volumetric Modulated Arc Therapy (VMAT), 5F Intensity Modulated Radiotherapy (IMRT) and 3D Conformal Radiotherapy (3DCRT) in Rectal Carcinoma Receiving Neoadjuvant Chemoradiotherapy

Can the Rectum Balloon Minimize Rectal Toxicity During Irradiation Therapy of Prostate Cancer?

Dose-escalated simultaneous integrated-boost treatment of prostate cancer patients via helical tomotherapy

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