Long-term survival and toxicity in patients treated with high-dose intensity modulated radiation therapy for localized prostate cancer Journal Article
| Authors: | Spratt, D. E.; Pei, X.; Yamada, J.; Kollmeier, M. A.; Cox, B.; Zelefsky, M. J. |
| Article Title: | Long-term survival and toxicity in patients treated with high-dose intensity modulated radiation therapy for localized prostate cancer |
| Abstract: | Purpose: To report long-term survival and toxicity outcomes with the use of high-dose intensity modulated radiation therapy (IMRT) to 86.4 Gy for patients with localized prostate cancer. Methods and Materials: Between August 1997 and December 2008, 1002 patients were treated to a dose of 86.4 Gy using a 5-7 field IMRT technique. Patients were stratified by prognostic risk group based on National Comprehensive Cancer Network risk classification criteria. A total of 587 patients (59%) were treated with neoadjuvant and concurrent androgen deprivation therapy. The median follow-up for the entire cohort was 5.5 years (range, 1-14 years). Results: For low-, intermediate-, and high-risk groups, 7-year biochemical relapse-free survival outcomes were 98.8%, 85.6%, and 67.9%, respectively (P<.001), and distant metastasis-free survival rates were 99.4%, 94.1%, and 82.0% (P<.001), respectively. On multivariate analysis, T stage (P<.001), Gleason score (P<.001), and >50% of initial biopsy positive core (P=.001) were predictive for distant mestastases. No prostate cancer-related deaths were observed in the low-risk group. The 7-year prostate cancer-specific mortality (PCSM) rates, using competing risk analysis for intermediate- and high-risk groups, were 3.3% and 8.1%, respectively (P=.008). On multivariate analysis, Gleason score (P=.004), percentage of biopsy core positivity (P=.003), and T-stage (P=.033) were predictive for PCSM. Actuarial 7-year grade 2 or higher late gastrointestinal and genitourinary toxicities were 4.4% and 21.1%, respectively. Late grade 3 gastrointestinal and genitourinary toxicity was experienced by 7 patients (0.7%) and 22 patients (2.2%), respectively. Of the 427 men with full potency at baseline, 317 men (74%) retained sexual function at time of last follow-up. Conclusions: This study represents the largest cohort of patients treated with high-dose radiation to 86.4 Gy, using IMRT for localized prostate cancer, with the longest follow-up to date. Our findings indicate that this treatment results in excellent clinical outcomes with acceptable toxicity. © 2013 Elsevier Inc. All rights reserved. |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 85 |
| Issue: | 3 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2013-03-01 |
| Start Page: | 686 |
| End Page: | 692 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2012.05.023 |
| PROVIDER: | scopus |
| PUBMED: | 22795805 |
| PMCID: | PMC5705018 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 March 2013" - "CODEN: IOBPD" - "Source: Scopus" |
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