Locally advanced prostatic cancer: Long-term toxicity outcome after three-dimensional conformal radiation therapy - A dose-escalation study Journal Article

Authors: Zelefsky, M. J.; Fuks, Z.; Wolfe, T.; Kutcher, G. J.; Burman, C.; Ling, C. C.; Venkatraman, E. S.; Leibel, S. A.
Article Title: Locally advanced prostatic cancer: Long-term toxicity outcome after three-dimensional conformal radiation therapy - A dose-escalation study
Abstract: PURPOSE: To determine the long-term effects of 75.6- and 81.0-Gy doses of three-dimensional conformal radiation therapy in a dose-escalation study in patients with stage T2c-T3 prostatic cancer. MATERIALS AND METHODS: Fifty patients received an initial 75.6-Gy dose, and the dose in 46 patients was subsequently escalated to 81.0-Gy. Median follow-up was 60 and 40 months, respectively. RESULTS: The rates of effects of acute toxicity during the course of treatment were similar for both dose levels. Among the 96 patients, the rate of grade 2 morbidities necessitating medication to relieve acute symptoms was 17% (16 patients) for rectal and 36% (35 patients) for urinary morbidities. All other patients had either no or grade 1 morbidities. Fourteen patients (15%) developed late grade 2 rectal morbidities. There were no differences in 5-year actuarial rates of late grade 2 rectal or urinary morbidities among patients who received 75.6 Gy versus those who received 81.0 Gy. One patient treated with 81.0 Gy developed a grade 3 urethral stricture, which was resolved with dilatation. CONCLUSION: Tumor dose escalation beyond conventional radiation doses for localized prostatic cancer is feasible when delivered with three-dimensional conformal radiation therapy, with no increase in morbidity in normal tissue.
Keywords: clinical article; controlled study; treatment outcome; clinical trial; treatment planning; cancer radiotherapy; radiation dose; chemotherapy, adjuvant; follow up; follow-up studies; prospective studies; prostate specific antigen; radiotherapy dosage; radiation injury; time factors; prostate cancer; prostatic neoplasms; leuprorelin; alkaline phosphatase; radiotherapy, conformal; phase 1 clinical trial; flutamide; rectum hemorrhage; acid phosphatase; micturition disorder; urethra stricture; actuarial analysis; humans; human; male; priority journal; article; prostate, neoplasms; radiations, injurious effects, complications of therapeutic radiology; prostate, therapeutic radiology
Journal Title: Radiology
Volume: 209
Issue: 1
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 1998-10-01
Start Page: 169
End Page: 174
Language: English
PUBMED: 9769828
PROVIDER: scopus
DOI: 10.1148/radiology.209.1.9769828
Notes: Article -- Export Date: 12 December 2016 -- Source: Scopus
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MSK Authors
  1. Venkatraman Ennapadam Seshan
    303 Seshan
  2. Chandra M Burman
    141 Burman
  3. Zvi Fuks
    342 Fuks
  4. Michael J Zelefsky
    655 Zelefsky
  5. Steven A Leibel
    240 Leibel
  6. Gerald J Kutcher
    76 Kutcher
  7. C Clifton Ling
    323 Ling
  8. Theresa J Wolfe
    4 Wolfe