Hypofractionated helical tomotherapy using 2.5–2.6 Gy daily fractions for localized prostate cancer

Guerra, José Luis López; Isa, N.; Matute, R.; Russo, Moisés; Puebla, F.; Kim, Michelle Miran; Sánchez-Reyes, A.; Beltran, C.; Jaen, J.; Bourgier, C.; Marsiglia, H.

doi:10.1007/s12094-012-0907-y

Cited by 10 publications

(7 citation statements)

References 27 publications

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“…Various trials did not find any correlation between the percentage of bladder volume receiving a certain radiation dose and urinary toxicity [23,24]. The results of prior studies by our group [15] and others [25,26] are consistent with these findings. Kuban et al [26] postulated that the dose-volume relation is confounded by changes in bladder volume throughout therapy, making it difficult to evaluate.…”

Section: Discussionsupporting

confidence: 90%

“…In order to improve RT results and decrease toxicity, important technologic advances have been made in the last years [15,18]. HT may reduce toxicity and improve patients' quality of life [19].…”

Section: Discussionmentioning

confidence: 99%

“…Specific constraints for femoral heads, rectum, and bladder were V50 < 5%, V60 < 35%, and V60 < 50%, respectively. PTV was defined by a 5-9 mm margin around the prostate/surgical bed (5 mm in the anteroposterior direction, 7 mm in the lateral direction, and 9 mm in the craniocaudal direction) [15]. The prescription dose covered at least 95% of the PTV.…”

Section: Methodsmentioning

confidence: 99%

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Image-Guided Radiation Therapy Based on Helical Tomotherapy in Prostate Cancer: Minimizing Toxicity

Acevedo-Henao

Guerra²,

Matute³

et al. 2014

Oncol Res Treat

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Background: We report the clinical results and prognostic factors of image-guided radiation therapy (RT) with helical tomotherapy (HT) for localized and recurrent prostate cancer (PC). Patients and Methods: We evaluated 70 patients with PC (primary diagnosis, n = 48; adjuvant, n = 5; salvage, n = 17) treated with HT from May 2006 through January 2011. The dose prescribed to the prostate/surgical bed ranged between 60 and 78 Gy. Potential risk factors for genitourinary (GU) and gastrointestinal (GI) toxicity were assessed. Results: The median age was 68 years (range 51-87 years). The median follow-up was 37 months (range 3-74 months). The rates of acute grade 2 GI and GU toxicities were 10 and 13%, respectively. Only 1 patient experienced acute grade 3 GU toxicity. The rates of late grade ≥ 2 GI and GU toxicities were 1% each. Multivariate analysis showed an association between rectum mean dose > median (39 Gy) and bladder median dose > median (46 Gy) with a higher grade of acute GI (p = 0.017) and GU (p = 0.019) toxicity, respectively. Additionally, older age was associated with late GU toxicity (p = 0.026). Conclusion: Toxicity with HT is low and is associated with higher median/mean doses in organs at risk as well as with older age. A prospective validation would be necessary to confirm these results.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Image-Guided Radiation Therapy Based on Helical Tomotherapy in Prostate Cancer: Minimizing Toxicity

Acevedo-Henao

Guerra²,

Matute³

et al. 2014

Oncol Res Treat

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“…Fourteen types of cancer (82%) were assessed in the present study. Prostate cancer: we included 24 observational studies ( n = 1170), with 3 studies involving recrudescent prostate cancer patients (Table ). After treatment with HT, the incidence of toxicity decreased as follows: Grade 3, long‐term toxicity and acute toxicity were 2.4%, 30%, and 70%, respectively.…”

Section: Resultsmentioning

confidence: 99%

Helical tomotherapy for cancer treatment: a rapid health technology assessment

Yang

Shen

et al. 2014

J Evidence Based Medicine

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The evidence of this study showed that, HT is safe and effective in clinic. But the abovementioned conclusion needs to be verified by conducting more high-quality studies with long-term follow-up. The costs of HT in procurement, maintenance, and application are high; and the skills, training, and qualification of operators are required. We suggest that the procurement of HT should be reduced; it should be allocated rationally and effectively used after comprehensive assessment in China's cancer epidemiology characteristics, health resource allocation, disease burden, medical service level, etc.; and also high-quality studies with long-term follow-up should be financially supported on the basis of establishing projects, so as to provide local evidence and consistently guide and improve scientific decision-making.

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“…A similar radiation dose escalation study was performed in 48 prostate cancer patients using regimens of 68.04 Gy at 2.52 Gy/fraction ( n = 32), 70 Gy at 2.5 Gy/fraction ( n = 5), and 70.2 Gy at 2.6 Gy/fraction. No patients developed grade 3–4 late toxicities ( 22 ). The safety of IGRT for hypofractionation was also corroborated in another study where patients with high-risk prostate cancer were treated up to 74.2 Gy in 2.65 Gy/fraction with the SIB technique.…”

Section: Radiation Dose Escalation For High-risk Prostate Cancer Patimentioning

confidence: 99%

Potential Applications of Image-Guided Radiotherapy for Radiation Dose Escalation in Patients with Early Stage High-Risk Prostate Cancer

Nguyen

Davis²,

Bose

et al. 2015

Front. Oncol.

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Patients with early stage high-risk prostate cancer (prostate specific antigen > 20, Gleason score > 7) are at high risk of recurrence following prostate cancer irradiation. Radiation dose escalation to the prostate may improve biochemical-free survival for these patients. However, high rectal and bladder dose with conventional three-dimensional conformal radiotherapy may lead to excessive gastrointestinal and genitourinary toxicity. Image-guided radiotherapy (IGRT), by virtue of combining the steep dose gradient of intensity-modulated radiotherapy and daily pretreatment imaging, may allow for radiation dose escalation and decreased treatment morbidity. Reduced treatment time is feasible with hypo-fractionated IGRT and it may improve patient quality of life.

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Hypofractionated helical tomotherapy using 2.5–2.6 Gy daily fractions for localized prostate cancer

Abstract: Hypofractionated HT in the treatment of localized prostate cancer is well tolerated with no grade 3 or higher early or late GI and GU toxicities. Further research is needed to assess definitive late toxicity and tumor control.

Cited by 10 publications

References 27 publications

Image-Guided Radiation Therapy Based on Helical Tomotherapy in Prostate Cancer: Minimizing Toxicity

Image-Guided Radiation Therapy Based on Helical Tomotherapy in Prostate Cancer: Minimizing Toxicity

Helical tomotherapy for cancer treatment: a rapid health technology assessment

Potential Applications of Image-Guided Radiotherapy for Radiation Dose Escalation in Patients with Early Stage High-Risk Prostate Cancer

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