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

Intensity-modulated radiation therapy: emerging cancer treatment technology

“…Several analyses suggest that the total volume of rectal wall exposed to greater than 60 -70 Gy predicts the rate of grade 2 (rectal bleeding) or more severe complications. Therefore, the implementation of IMRT, with the ability to further reduce rectal dose (Figure 2), should further reduce toxicities, as has recently been reported (Zelefsky et al, 2002).…”

Particle therapy in prostate cancer: a review

“…In fact, dose escalation with photons has been shown to yield outstanding biochemical control rates in all risk categories, and is associated with minimal treatmentrelated late toxicity when delivered with high-precision techniques. 3,23 High-LET radiation: light ions Like neutrons, light ions, such as neon and carbon ions, have a significantly higher RBE than photons, but due to their prominent Bragg peak display exquisite dose distributions, similar to those of protons. The improved dose distributions to nontarget tissues may result in significantly lower normal tissue complication probabilities, and reduced risk of radiation-induced malignancies compared to neutrons.…”

“…Clinical dose-escalation studies, both retrospective and randomized, have corroborated this notion. [1][2][3][4][5][6][7][8] The optimal dose with regard to local tumor control and normal tissue tolerance in the treatment of adenocarcinoma of the prostate, however, remains unclear. Statistically significant improvements with dose escalation in terms of freedom from biochemical failure (bNED) have already been shown by two randomized studies using photons 2 or combined photons and proton boost.…”

“…Intensity-modulated radiotherapy (IMRT) represents the most sophisticated form of X-ray irradiation and has been shown to be an effective tool for safe dose escalation in prostate cancer. 3,13,14 Some have raised concerns that the increased integral doses to surrounding normal tissues subsequent to IMRT delivery may elevate the risk of induced secondary malignancy development. 15,16 This is still a rather controversial issue which will be addressed in more detail in the section on radiation-induced carcinogenesis below.…”

Health-related quality-of-life after external beam radiation therapy for localized prostate cancer: intensity-modulated radiation therapy versus conformal radiation therapy

“…5 The recently developed intensitymodulated radiation therapy (IMRT) has been shown to improve local control and disease-free survival in patients with localized prostate cancer. 6 Zelefsky et al 7 reported that IMRT significantly reduced acute and rectal toxicities compared to conventional radiotherapy techniques despite a significant dose escalation.…”