High Dose Radiation Delivered by Intensity Modulated Conformal Radiotherapy Improves the Outcome of Localized Prostate Cancer

Abstract

Sophisticated conformal radiotherapy techniques with high dose 3-D conformal and intensity modulated radiation therapy improve the biochemical outcome in patients with favorable, intermediate and unfavorable risk prostate cancer. Intensity modulated radiation therapy is associated with minimal rectal and bladder toxicity, and, hence, represents the treatment delivery approach with the most favorable risk-to-benefit ratio.

Reduced rectal toxicity with ultrasound-based image guided radiotherapy using BAT™ (B-mode acquisition and targeting system) for prostate cancer

“…Because of higher doses, margins needed to compensate prostate motion [2,14] and other treatment uncertainties, there is an increased risk of dose limiting side effects [9,32] or underdosing the target. To minimize toxicity while delivering high doses to the target, a possible solution would be to localize the prostate position daily before treatment.…”

Influence of Rectum Delineation (Rectal Volume vs. Rectal Wall) on IMRT Treatment Planning of the Prostate

“…In primary treatment of localized prostate cancer with external-beam radiotherapy, the advantage of dose escalation has been demonstrated in retrospective [15,21,29] and prospective [22] studies. Late rectal toxicity, in particular late rectal bleeding, is considered the limiting factor [17,24].…”

Radiation Oncology Physician Practice in the Modern Era: A Statewide Analysis of Medicare Reimbursement

“…For instance, a recent study demonstrated that increased use of lung IMRT reduced the likelihood of hospitalization for dehydration or pulmonary toxicity [19]. Improving normal tissue dose distributions beyond three-dimensional conformal radiotherapy clearly contributes to reduced morbidity for breast, prostate cancer and head and neck cancer patients [4,[20][21]. IMRT is clearly justified when advanced technology enables dose escalation thereby improving locoregional tumor control [22].…”