Ultra-High Dose (86.4 Gy) IMRT for Localized Prostate Cancer: Toxicity and Biochemical Outcomes
Purpose To report toxicity and preliminary biochemical outcomes with high-dose intensity-modulated radiation therapy (IMRT) to a dose of 86.4 Gy for localized prostate cancer. Methods and Materials Between August 1997 and March 2004, 478 patients were treated with 86.4 Gy using a 5- to 7-field IMRT...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2008-06, Vol.71 (2), p.330-337 |
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| creator | Cahlon, Oren, M.D Zelefsky, Michael J., M.D Shippy, Alison, B.A Chan, Heather, B.A Fuks, Zvi, M.D Yamada, Yoshiya, M.D Hunt, Margie, M.S Greenstein, Steven, B.A Amols, Howard, Ph.D |
| description | Purpose To report toxicity and preliminary biochemical outcomes with high-dose intensity-modulated radiation therapy (IMRT) to a dose of 86.4 Gy for localized prostate cancer. Methods and Materials Between August 1997 and March 2004, 478 patients were treated with 86.4 Gy using a 5- to 7-field IMRT technique. To adhere to normal tissue constraints, the mean D95 and V100 for the planning target volume were 83 Gy and 87%, respectively. Toxicity data were scored according to the Common Terminology Criteria for Adverse Events Version 3.0. Freedom from biochemical relapse was calculated. The median follow-up was 53 months. Results Thirty-seven patients (8%) experienced acute Grade 2 gastrointestinal (GI) toxicity. There was no acute Grade 3 or 4 GI toxicity. One hundred and five patients (22%) experienced acute Grade 2 genitourinary (GU) toxicity and three patients (0.6%) had Grade 3 GU toxicity. There was no acute Grade 4 GU toxicity. Sixteen patients (3%) developed late Grade 2 GI toxicity and two patients ( |
| doi_str_mv | 10.1016/j.ijrobp.2007.10.004 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_21124259</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S036030160704374X</els_id><sourcerecordid>19484862</sourcerecordid><originalsourceid>FETCH-LOGICAL-c602t-117bb2d0d4db1b14073192497a892f543a4994166922ffd08c55f7a1212308bb3</originalsourceid><addsrcrecordid>eNqNklGL1DAQgIso3nr6D0QCgpwPrTNp2qb3IHir3h2snOge3FtI09RNbZs1acX115vSBcEX7ykwfDOZmW-i6DlCgoD5mzYxrbPVPqEARQglAOxBtEJelHGaZXcPoxWkOcRpgE-iJ963AIBYsMfRCXLMGc_4KhK33ehkfGW-7ch76zU543nCyOXhNbn-9GVLGuvIxirZmd-6Jp-d9aMcNVnLQWl3Trb2l1FmPBA51OTCWLXTvQk0uZlGZXvtn0aPGtl5_ez4nka3Hz9s11fx5ubyev1uE6sc6BiHvqqK1lCzusIKGRQplpSVheQlbTKWSlaWDPO8pLRpauAqy5pCIkWaAq-q9DR6udQNDRrhQ09a7ZQdBq1GQREpo1kZqFcLtXf2x6T9KHrjle46OWg7eYFlxlkG_F4gFgj3ABlnPKcBZAuowg69043YO9NLdxAIYhYqWrEIFbPQORqEhrQXx_pT1ev6b9LRYADeLoAO2_1ptJuH18FObdw8e23N_374t4DqzDBL_K4P2rd2ckMwJ1B4KkB8nY9qvikoQnLB7tI_iuzD7w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>19484862</pqid></control><display><type>article</type><title>Ultra-High Dose (86.4 Gy) IMRT for Localized Prostate Cancer: Toxicity and Biochemical Outcomes</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Cahlon, Oren, M.D ; Zelefsky, Michael J., M.D ; Shippy, Alison, B.A ; Chan, Heather, B.A ; Fuks, Zvi, M.D ; Yamada, Yoshiya, M.D ; Hunt, Margie, M.S ; Greenstein, Steven, B.A ; Amols, Howard, Ph.D</creator><creatorcontrib>Cahlon, Oren, M.D ; Zelefsky, Michael J., M.D ; Shippy, Alison, B.A ; Chan, Heather, B.A ; Fuks, Zvi, M.D ; Yamada, Yoshiya, M.D ; Hunt, Margie, M.S ; Greenstein, Steven, B.A ; Amols, Howard, Ph.D</creatorcontrib><description>Purpose To report toxicity and preliminary biochemical outcomes with high-dose intensity-modulated radiation therapy (IMRT) to a dose of 86.4 Gy for localized prostate cancer. Methods and Materials Between August 1997 and March 2004, 478 patients were treated with 86.4 Gy using a 5- to 7-field IMRT technique. To adhere to normal tissue constraints, the mean D95 and V100 for the planning target volume were 83 Gy and 87%, respectively. Toxicity data were scored according to the Common Terminology Criteria for Adverse Events Version 3.0. Freedom from biochemical relapse was calculated. The median follow-up was 53 months. Results Thirty-seven patients (8%) experienced acute Grade 2 gastrointestinal (GI) toxicity. There was no acute Grade 3 or 4 GI toxicity. One hundred and five patients (22%) experienced acute Grade 2 genitourinary (GU) toxicity and three patients (0.6%) had Grade 3 GU toxicity. There was no acute Grade 4 GU toxicity. Sixteen patients (3%) developed late Grade 2 GI toxicity and two patients (<1%) developed late Grade 3 GI toxicity. Sixty patients (13%) had late Grade 2 GU toxicity and 12 (<3%) experienced late Grade 3 GU toxicity. The 5-year actuarial PSA relapse-free survival according to the nadir plus 2 ng/mL definition was 98%, 85% and 70% for the low, intermediate, and high risk NCCN prognostic groups. Conclusion This report represents the largest data set of patients treated to ultra-high radiation dose levels of 86.4 Gy using IMRT for localized prostate cancer. Our findings indicate that this treatment is well tolerated and the early excellent biochemical control rates are encouraging.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2007.10.004</identifier><identifier>PMID: 18164858</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute Disease ; Aged ; Aged, 80 and over ; CARCINOMAS ; Dose escalation ; Erectile Dysfunction - etiology ; Feasibility Studies ; Follow-Up Studies ; Gastrointestinal Tract - radiation effects ; Hematology, Oncology and Palliative Medicine ; Humans ; IMRT ; Male ; Middle Aged ; Outcomes ; PATIENTS ; PLANNING ; PROSTATE ; Prostate cancer ; Prostate-Specific Antigen - blood ; Prostatic Neoplasms - blood ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - radiotherapy ; RADIATION DOSES ; Radiation Injuries ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated - methods ; TOXICITY ; Urogenital System - radiation effects</subject><ispartof>International journal of radiation oncology, biology, physics, 2008-06, Vol.71 (2), p.330-337</ispartof><rights>Elsevier Inc.</rights><rights>2008 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c602t-117bb2d0d4db1b14073192497a892f543a4994166922ffd08c55f7a1212308bb3</citedby><cites>FETCH-LOGICAL-c602t-117bb2d0d4db1b14073192497a892f543a4994166922ffd08c55f7a1212308bb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2007.10.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18164858$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/21124259$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Cahlon, Oren, M.D</creatorcontrib><creatorcontrib>Zelefsky, Michael J., M.D</creatorcontrib><creatorcontrib>Shippy, Alison, B.A</creatorcontrib><creatorcontrib>Chan, Heather, B.A</creatorcontrib><creatorcontrib>Fuks, Zvi, M.D</creatorcontrib><creatorcontrib>Yamada, Yoshiya, M.D</creatorcontrib><creatorcontrib>Hunt, Margie, M.S</creatorcontrib><creatorcontrib>Greenstein, Steven, B.A</creatorcontrib><creatorcontrib>Amols, Howard, Ph.D</creatorcontrib><title>Ultra-High Dose (86.4 Gy) IMRT for Localized Prostate Cancer: Toxicity and Biochemical Outcomes</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose To report toxicity and preliminary biochemical outcomes with high-dose intensity-modulated radiation therapy (IMRT) to a dose of 86.4 Gy for localized prostate cancer. Methods and Materials Between August 1997 and March 2004, 478 patients were treated with 86.4 Gy using a 5- to 7-field IMRT technique. To adhere to normal tissue constraints, the mean D95 and V100 for the planning target volume were 83 Gy and 87%, respectively. Toxicity data were scored according to the Common Terminology Criteria for Adverse Events Version 3.0. Freedom from biochemical relapse was calculated. The median follow-up was 53 months. Results Thirty-seven patients (8%) experienced acute Grade 2 gastrointestinal (GI) toxicity. There was no acute Grade 3 or 4 GI toxicity. One hundred and five patients (22%) experienced acute Grade 2 genitourinary (GU) toxicity and three patients (0.6%) had Grade 3 GU toxicity. There was no acute Grade 4 GU toxicity. Sixteen patients (3%) developed late Grade 2 GI toxicity and two patients (<1%) developed late Grade 3 GI toxicity. Sixty patients (13%) had late Grade 2 GU toxicity and 12 (<3%) experienced late Grade 3 GU toxicity. The 5-year actuarial PSA relapse-free survival according to the nadir plus 2 ng/mL definition was 98%, 85% and 70% for the low, intermediate, and high risk NCCN prognostic groups. Conclusion This report represents the largest data set of patients treated to ultra-high radiation dose levels of 86.4 Gy using IMRT for localized prostate cancer. Our findings indicate that this treatment is well tolerated and the early excellent biochemical control rates are encouraging.</description><subject>Acute Disease</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>CARCINOMAS</subject><subject>Dose escalation</subject><subject>Erectile Dysfunction - etiology</subject><subject>Feasibility Studies</subject><subject>Follow-Up Studies</subject><subject>Gastrointestinal Tract - radiation effects</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>IMRT</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Outcomes</subject><subject>PATIENTS</subject><subject>PLANNING</subject><subject>PROSTATE</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatic Neoplasms - blood</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>RADIATION DOSES</subject><subject>Radiation Injuries</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy, Intensity-Modulated - methods</subject><subject>TOXICITY</subject><subject>Urogenital System - radiation effects</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNklGL1DAQgIso3nr6D0QCgpwPrTNp2qb3IHir3h2snOge3FtI09RNbZs1acX115vSBcEX7ykwfDOZmW-i6DlCgoD5mzYxrbPVPqEARQglAOxBtEJelHGaZXcPoxWkOcRpgE-iJ963AIBYsMfRCXLMGc_4KhK33ehkfGW-7ch76zU543nCyOXhNbn-9GVLGuvIxirZmd-6Jp-d9aMcNVnLQWl3Trb2l1FmPBA51OTCWLXTvQk0uZlGZXvtn0aPGtl5_ez4nka3Hz9s11fx5ubyev1uE6sc6BiHvqqK1lCzusIKGRQplpSVheQlbTKWSlaWDPO8pLRpauAqy5pCIkWaAq-q9DR6udQNDRrhQ09a7ZQdBq1GQREpo1kZqFcLtXf2x6T9KHrjle46OWg7eYFlxlkG_F4gFgj3ABlnPKcBZAuowg69043YO9NLdxAIYhYqWrEIFbPQORqEhrQXx_pT1ev6b9LRYADeLoAO2_1ptJuH18FObdw8e23N_374t4DqzDBL_K4P2rd2ckMwJ1B4KkB8nY9qvikoQnLB7tI_iuzD7w</recordid><startdate>20080601</startdate><enddate>20080601</enddate><creator>Cahlon, Oren, M.D</creator><creator>Zelefsky, Michael J., M.D</creator><creator>Shippy, Alison, B.A</creator><creator>Chan, Heather, B.A</creator><creator>Fuks, Zvi, M.D</creator><creator>Yamada, Yoshiya, M.D</creator><creator>Hunt, Margie, M.S</creator><creator>Greenstein, Steven, B.A</creator><creator>Amols, Howard, Ph.D</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>OTOTI</scope></search><sort><creationdate>20080601</creationdate><title>Ultra-High Dose (86.4 Gy) IMRT for Localized Prostate Cancer: Toxicity and Biochemical Outcomes</title><author>Cahlon, Oren, M.D ; Zelefsky, Michael J., M.D ; Shippy, Alison, B.A ; Chan, Heather, B.A ; Fuks, Zvi, M.D ; Yamada, Yoshiya, M.D ; Hunt, Margie, M.S ; Greenstein, Steven, B.A ; Amols, Howard, Ph.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c602t-117bb2d0d4db1b14073192497a892f543a4994166922ffd08c55f7a1212308bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Acute Disease</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>CARCINOMAS</topic><topic>Dose escalation</topic><topic>Erectile Dysfunction - etiology</topic><topic>Feasibility Studies</topic><topic>Follow-Up Studies</topic><topic>Gastrointestinal Tract - radiation effects</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>IMRT</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Outcomes</topic><topic>PATIENTS</topic><topic>PLANNING</topic><topic>PROSTATE</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatic Neoplasms - blood</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>RADIATION DOSES</topic><topic>Radiation Injuries</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy, Intensity-Modulated - methods</topic><topic>TOXICITY</topic><topic>Urogenital System - radiation effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cahlon, Oren, M.D</creatorcontrib><creatorcontrib>Zelefsky, Michael J., M.D</creatorcontrib><creatorcontrib>Shippy, Alison, B.A</creatorcontrib><creatorcontrib>Chan, Heather, B.A</creatorcontrib><creatorcontrib>Fuks, Zvi, M.D</creatorcontrib><creatorcontrib>Yamada, Yoshiya, M.D</creatorcontrib><creatorcontrib>Hunt, Margie, M.S</creatorcontrib><creatorcontrib>Greenstein, Steven, B.A</creatorcontrib><creatorcontrib>Amols, Howard, Ph.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cahlon, Oren, M.D</au><au>Zelefsky, Michael J., M.D</au><au>Shippy, Alison, B.A</au><au>Chan, Heather, B.A</au><au>Fuks, Zvi, M.D</au><au>Yamada, Yoshiya, M.D</au><au>Hunt, Margie, M.S</au><au>Greenstein, Steven, B.A</au><au>Amols, Howard, Ph.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultra-High Dose (86.4 Gy) IMRT for Localized Prostate Cancer: Toxicity and Biochemical Outcomes</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2008-06-01</date><risdate>2008</risdate><volume>71</volume><issue>2</issue><spage>330</spage><epage>337</epage><pages>330-337</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>Purpose To report toxicity and preliminary biochemical outcomes with high-dose intensity-modulated radiation therapy (IMRT) to a dose of 86.4 Gy for localized prostate cancer. Methods and Materials Between August 1997 and March 2004, 478 patients were treated with 86.4 Gy using a 5- to 7-field IMRT technique. To adhere to normal tissue constraints, the mean D95 and V100 for the planning target volume were 83 Gy and 87%, respectively. Toxicity data were scored according to the Common Terminology Criteria for Adverse Events Version 3.0. Freedom from biochemical relapse was calculated. The median follow-up was 53 months. Results Thirty-seven patients (8%) experienced acute Grade 2 gastrointestinal (GI) toxicity. There was no acute Grade 3 or 4 GI toxicity. One hundred and five patients (22%) experienced acute Grade 2 genitourinary (GU) toxicity and three patients (0.6%) had Grade 3 GU toxicity. There was no acute Grade 4 GU toxicity. Sixteen patients (3%) developed late Grade 2 GI toxicity and two patients (<1%) developed late Grade 3 GI toxicity. Sixty patients (13%) had late Grade 2 GU toxicity and 12 (<3%) experienced late Grade 3 GU toxicity. The 5-year actuarial PSA relapse-free survival according to the nadir plus 2 ng/mL definition was 98%, 85% and 70% for the low, intermediate, and high risk NCCN prognostic groups. Conclusion This report represents the largest data set of patients treated to ultra-high radiation dose levels of 86.4 Gy using IMRT for localized prostate cancer. Our findings indicate that this treatment is well tolerated and the early excellent biochemical control rates are encouraging.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>18164858</pmid><doi>10.1016/j.ijrobp.2007.10.004</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 0360-3016 |
| ispartof | International journal of radiation oncology, biology, physics, 2008-06, Vol.71 (2), p.330-337 |
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| language | eng |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Acute Disease Aged Aged, 80 and over CARCINOMAS Dose escalation Erectile Dysfunction - etiology Feasibility Studies Follow-Up Studies Gastrointestinal Tract - radiation effects Hematology, Oncology and Palliative Medicine Humans IMRT Male Middle Aged Outcomes PATIENTS PLANNING PROSTATE Prostate cancer Prostate-Specific Antigen - blood Prostatic Neoplasms - blood Prostatic Neoplasms - pathology Prostatic Neoplasms - radiotherapy RADIATION DOSES Radiation Injuries Radiology RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Radiotherapy Dosage Radiotherapy, Intensity-Modulated - methods TOXICITY Urogenital System - radiation effects |
| title | Ultra-High Dose (86.4 Gy) IMRT for Localized Prostate Cancer: Toxicity and Biochemical Outcomes |
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