OBJECTIVES: To evaluate the feasibility of intensity-modulated radiotherapy with simultaneous integrated boost to the dominant intraprostatic lesion for definitive treatment of prostate cancer. MATERIALS AND METHODS: Patients were deemed eligible for the study if they had histologically proven stage cT2-T3 N0M0 prostate adenocarcinoma. In addition <20% risk of lymph nodal involvement according to Roach formula, was required for enrollment. Patients were treated with intensity-modulated radiotherapy with simultaneous integrated boost technique to the dominant intraprostatic lesion defined by magnetic resonance imaging. The prescribed dose to the prostate and seminal vesicles was 72 Gy (1.8 Gy per fraction). The dose delivered to the intraprostatic lesion received was 80 Gy (2 Gy per fraction). Acute gastrointestinal (GI) and genitourinary (GU) toxicity was evaluated weekly during treatment, and at 1 and 3 months thereafter. Late GI and GU toxicity was evaluated by Kaplan Meier method. RESULTS: Forty patients were deemed evaluable. Acute and late GI and GU toxicity were evaluated in all patients. Two patients (5%) developed acute grade 3 GI toxicity and 1 patient (2.5%) developed acute grade 3 GU toxicity. No grade 4 acute GI or GU toxicity occurred. With a median follow-up of 19 months (interquartile range, 15 to 26 mo), the 2-year actuarial cumulative incidence of grade ≥2 rectal toxicity was 9.5%. The 2-year actuarial cumulative incidence of grade ≥2 urinary toxicity was 13.3%. CONCLUSIONS: Treatment related acute toxicity was low in our cohort. Prolonged observation with a larger series of patients is necessary to evaluate late toxicity and local control.

Ippolito, E., Mantini, G., Morganti, A. G., Mazzeo, E., Padula, G., Digesu', C., Cilla, S., Frascino, V., Luzi, S., Massaccesi, M., Macchia, G., Deodato, F., Mattiucci, G. C., Piermattei, A., Cellini, N., Intensity-modulated radiotherapy with simultaneous integrated boost to dominant intraprostatic lesion: preliminary report on toxicity, <<AMERICAN JOURNAL OF CLINICAL ONCOLOGY: CANCER CLINICAL TRIALS>>, 2012; 35 (2): 158-162. [doi:10.1097/COC.0b013e318209cd8f] [http://hdl.handle.net/10807/32859]

Intensity-modulated radiotherapy with simultaneous integrated boost to dominant intraprostatic lesion: preliminary report on toxicity

Ippolito, Edy;Mantini, Giovanna;Morganti, Alessio Giuseppe;Mazzeo, Ercole;Digesu', Cinzia;Cilla, Savino;Frascino, Vincenzo;Luzi, Stefano;Massaccesi, Mariangela;Macchia, Gabriella;Deodato, Francesco;Mattiucci, Gian Carlo;Piermattei, Angelo;Cellini, Numa
2012

Abstract

OBJECTIVES: To evaluate the feasibility of intensity-modulated radiotherapy with simultaneous integrated boost to the dominant intraprostatic lesion for definitive treatment of prostate cancer. MATERIALS AND METHODS: Patients were deemed eligible for the study if they had histologically proven stage cT2-T3 N0M0 prostate adenocarcinoma. In addition <20% risk of lymph nodal involvement according to Roach formula, was required for enrollment. Patients were treated with intensity-modulated radiotherapy with simultaneous integrated boost technique to the dominant intraprostatic lesion defined by magnetic resonance imaging. The prescribed dose to the prostate and seminal vesicles was 72 Gy (1.8 Gy per fraction). The dose delivered to the intraprostatic lesion received was 80 Gy (2 Gy per fraction). Acute gastrointestinal (GI) and genitourinary (GU) toxicity was evaluated weekly during treatment, and at 1 and 3 months thereafter. Late GI and GU toxicity was evaluated by Kaplan Meier method. RESULTS: Forty patients were deemed evaluable. Acute and late GI and GU toxicity were evaluated in all patients. Two patients (5%) developed acute grade 3 GI toxicity and 1 patient (2.5%) developed acute grade 3 GU toxicity. No grade 4 acute GI or GU toxicity occurred. With a median follow-up of 19 months (interquartile range, 15 to 26 mo), the 2-year actuarial cumulative incidence of grade ≥2 rectal toxicity was 9.5%. The 2-year actuarial cumulative incidence of grade ≥2 urinary toxicity was 13.3%. CONCLUSIONS: Treatment related acute toxicity was low in our cohort. Prolonged observation with a larger series of patients is necessary to evaluate late toxicity and local control.
2012
Inglese
Ippolito, E., Mantini, G., Morganti, A. G., Mazzeo, E., Padula, G., Digesu', C., Cilla, S., Frascino, V., Luzi, S., Massaccesi, M., Macchia, G., Deodato, F., Mattiucci, G. C., Piermattei, A., Cellini, N., Intensity-modulated radiotherapy with simultaneous integrated boost to dominant intraprostatic lesion: preliminary report on toxicity, <<AMERICAN JOURNAL OF CLINICAL ONCOLOGY: CANCER CLINICAL TRIALS>>, 2012; 35 (2): 158-162. [doi:10.1097/COC.0b013e318209cd8f] [http://hdl.handle.net/10807/32859]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/32859
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