Patterns of treatment failure in patients with prostate cancer treated with 76–80 Gy radiotherapy to the prostate and seminal vesicles ± hormonotherapy

López-Torrecilla, J.; Pastor-Peidro, J; Vicedo-Gonzalez, A.; González-Sanchis, D; A, Hernandez-Machancoses; Almendros-Blanco, Piedad; E, García-Miragall; Gordo-Partearroyo, J C; Garcia-Hernandez, T; Brualla-González, L.; Granero-Cabañero, D.; Roselló-Ferrando, Joan

doi:10.1007/s12094-020-02437-0

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…Although chemotherapy has been established as effective in castration-resistant prostate cancer [ 13 , 14 ], it is noteworthy that, in this case, the addition of PBT rendered additional chemotherapy unnecessary. It is known that recurrence near the apex of the prostate is common [ 15 ]. It was previously reported that 69 of 77 patients (90%) who underwent salvage radical prostatectomy and did not respond to initial RT had recurrence tumors at the apex.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Control With Proton Beam Therapy for Recurrent Prostate Cancer in the Right Perineum Following Intensity-Modulated Radiation Therapy: A Case Report

Ishikawa,

Suzuki,

Seto

et al. 2024

Cureus

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Radiation therapy (RT) is commonly used for the treatment of prostate cancer, with intensity-modulated radiation therapy (IMRT) and proton beam therapy (PBT) being the utilized modalities. This case report outlines the treatment course of a recurrent prostate cancer lesion in the right perineal musculature managed with proton therapy following IMRT. A 64-year-old Japanese man, diagnosed with prostate cancer and categorized as high risk according to the National Comprehensive Cancer Network guidelines, underwent six months of androgen deprivation therapy, which included bicalutamide and degarelix acetate. Six months after completing 78 Gy in 39 fractions of IMRT, the patient reported perineal to anal pain. Laboratory tests showed an elevated serum prostate-specific antigen (PSA) level, and pelvic MRI showed a mass lesion in the right perineal musculature. Consequently, the patient was diagnosed with recurrent prostate cancer. Thereafter, the patient underwent eight cycles of systemic chemotherapy with docetaxel; however, his pain progressively worsened. Subsequently, the treatment was switched to 12 cycles of cabazitaxel, which led to gradual pain relief. The patient received PBT at 60 Gy relative biological effectiveness in 30 fractions for the recurrent lesion. Five years after PBT, pelvic MRI showed no mass lesions in the prostate or surrounding tissues. The PSA levels remained low, less than 0.008 ng/ml, and there were no apparent late complications.

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Section: Discussionmentioning

confidence: 99%

Long-Term Control With Proton Beam Therapy for Recurrent Prostate Cancer in the Right Perineum Following Intensity-Modulated Radiation Therapy: A Case Report

Ishikawa,

Suzuki,

Seto

et al. 2024

Cureus

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“…IMRT is the standard radiation modality used in the treatment of high-risk localized prostate cancer. A recent study with IMRT at a dose of 76–80 Gy plus ADT, which was administrated in 78.5% of the patients with NCCN high-risk localized prostate carcinoma, reported 5-year bDFS and metastasis-free survival rates of 80.6% and 92.5%, respectively [ 25 ]. Simizu et al (2017) have described clinical outcomes after IMRT (72.6–74.8 Gy in 2.2 Gy per fraction) plus ADT administrated to 61% of the patients with high-risk prostate carcinoma and report 5-year bDFS and clinical RFS rates of 77% and 87%, respectively [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Intensity-Modulated Radiotherapy with Regional Hyperthermia for High-Risk Localized Prostate Carcinoma

Nakahara

Ohguri

Kakinouchi

et al. 2022

Cancers

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Background: The purpose of this study was to evaluate the efficacy and toxicity of adding regional hyperthermia to intensity-modulated radiotherapy (IMRT) plus neoadjuvant androgen deprivation therapy (ADT) for high-risk localized prostate carcinoma. Methods: Data from 121 consecutive patients with high-risk prostate carcinoma who were treated with IMRT were retrospectively analyzed. The total planned dose of IMRT was 76 Gy in 38 fractions for all patients; hyperthermia was used in 70 of 121 patients. Intra-rectal temperatures at the prostate level were measured to evaluate thermal dose. Results: Median number of heating sessions was five and the median total thermal dose of CEM43T90 was 7.5 min. Median follow-up duration was 64 months. Addition of hyperthermia to IMRT predicted better clinical relapse-free survival. Higher thermal dose with CEM43T90 (>7 min) predicted improved biochemical disease-free survival. The occurrence of acute and delayed toxicity ≥Grade 2 was not significantly different between patients with or without hyperthermia. Conclusions: IMRT plus regional hyperthermia represents a promising approach with acceptable toxicity for high-risk localized prostate carcinoma. Further studies are needed to verify the efficacy of this combined treatment.

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“…Many studies had confirmed that increasing the prescription dose to 78–80 Gy in conventional fraction could significantly improve BFFS and reduce PC-related mortality. 14 , 15 , 16 According to the National Comprehensive Cancer Network (NCCN) guidelines of 2005, the prescription dose for low-risk patients should reach to 70– 75 Gy, while for patients with intermediate- and high-risk that should be up to 75–80 Gy in conventional fraction. 17 However, as the dose was further increased, the incidence of severe GU and GI toxicities would increase significantly, which limited the benefit from dose-escalation with CFRT.…”

Section: Discussionmentioning

confidence: 99%

Moderate hypofractionated helical tomotherapy for older patients with localized prostate cancer: long-term outcomes of a phase I–II trial

Cui

Wang

et al. 2022

Radiology and Oncology

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Background Our previous study showed that two different regimens of moderate hypofractionated radiotherapy (HFRT) delivered with helical tomotherapy (HT) are well tolerated in older prostate cancer patients. We provide a longterm efficacy and toxicity after > 7 years of follow-up. Patients and methods The study recruited 33 patients from February 2009 to July 2011 (76 Gy/34F; Group-1); and 34 from July 2011 to February 2014 (71.6 Gy/28F; 50.4 Gy/25F for the risk of pelvic lymph nodes involvement (LNI) >15%; Group-2). The primary outcomes were biochemical failure (BF), biochemical failure and clinical disease failure (BCDF), progression-free survival (PFS), overall survival (OS), late genitourinary (GU) and gastrointestinal (GI) toxicity. Results The average ages of two groups were 80 and 77 years and the proportions of patients with LNI > 15% were 69.7% and 73.5%, respectively. At the final follow-up in February 2020, 27.3% and 20.6% cases experienced BF, with a median time until BF of 3.3 years. A total of 38.8% patients reached primary endpoints, in which 18 deaths were reported BCDF events (45.5% vs. 32.4%, p = 0.271). There was no significant difference in 7-year PFS (68.6% vs. 74.8%, p = 0.591), BCDF (45.5% vs. 32.4%, p = 0.271) and OS (71.9% vs. 87.5%, p = 0.376) for full set analysis and for subgroup analysis (all p > 0.05). The incidence of grade ≥ 2 late GU (6.2% vs. 6.3%, p = 0.127) and GI toxicities (9.4% vs. 15.6%, p = 0.554) was comparable. Conclusions In older patients with localized prostate cancer, two moderate hypofractionated regimens were all well tolerated with similar, mild late toxicities and satisfactory survival, without necessity of prophylactic pelvic node irradiation.

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Patterns of treatment failure in patients with prostate cancer treated with 76–80 Gy radiotherapy to the prostate and seminal vesicles ± hormonotherapy

Cited by 4 publications

References 20 publications

Long-Term Control With Proton Beam Therapy for Recurrent Prostate Cancer in the Right Perineum Following Intensity-Modulated Radiation Therapy: A Case Report

Long-Term Control With Proton Beam Therapy for Recurrent Prostate Cancer in the Right Perineum Following Intensity-Modulated Radiation Therapy: A Case Report

Intensity-Modulated Radiotherapy with Regional Hyperthermia for High-Risk Localized Prostate Carcinoma

Moderate hypofractionated helical tomotherapy for older patients with localized prostate cancer: long-term outcomes of a phase I–II trial

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