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Prostate cancer treated with reduced-volume intensity-modulated radiation therapy: Report on the 5-year outcome of a prospective series.

Abstract How to define a clinical target volume (CTV) as small as possible for prostate cancer to reduce the dose received by normal organs is an interesting study. We conduct a research to analyze the clinical efficacy of intensity modulated radiotherapy (IMRT) using reduced CTV in the treatment of prostate cancer. From January 2006 to June 2010, 78 patients with prostate cancer were treated with IMRT according to this institutional protocol. Of them, 18 had stage II tumors, 39 had stage III tumors, and 21 had stage IVa tumors. Clinical outcomes included overall survival, biochemical recurrence, recurrence-free survival, and acute and chronic injuries caused by radiotherapy. Risk factors were evaluated using the Cox regression model. As of December 31, 2014, all patients completed radiotherapy as planned. Myelosuppression was mostly grade 1, acute urinary injury was mostly grades 1 and 2, and intestinal injury was mostly grade 1. The 5-year follow-up rate was 91.0%. The overall, progression-free, biochemical recurrence-free, and distant metastasis-free survival rates were 82.1%, 79.4%, 84.6%, and 94.9%, respectively. Tumor volumes defined by small target volumes and Radiation Therapy Oncology Group were 274.21 ± 92.64 and 600.68 ± 113.72, respectively, representing a significant difference (P < .05). Age, prostate-specific antigen level, eastern cooperative oncology Group score, Gleason score, and volume of CTV were independent risk factors for mortality and disease progression. Our findings indicated that IMRT with reduced CTV have less acute and chronic injuries caused by radiation, particularly grade 3 or higher urinary and intestinal injuries, while ensuring survival benefits and protecting the hematopoietic function.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29384928
OWN - NLM
STAT- In-Process
LR  - 20180131
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 52
DP  - 2017 Dec
TI  - Prostate cancer treated with reduced-volume intensity-modulated radiation
      therapy: Report on the 5-year outcome of a prospective series.
PG  - e9450
LID - 10.1097/MD.0000000000009450 [doi]
AB  - How to define a clinical target volume (CTV) as small as possible for prostate
      cancer to reduce the dose received by normal organs is an interesting study. We
      conduct a research to analyze the clinical efficacy of intensity modulated
      radiotherapy (IMRT) using reduced CTV in the treatment of prostate cancer. From
      January 2006 to June 2010, 78 patients with prostate cancer were treated with
      IMRT according to this institutional protocol. Of them, 18 had stage II tumors,
      39 had stage III tumors, and 21 had stage IVa tumors. Clinical outcomes included 
      overall survival, biochemical recurrence, recurrence-free survival, and acute and
      chronic injuries caused by radiotherapy. Risk factors were evaluated using the
      Cox regression model. As of December 31, 2014, all patients completed
      radiotherapy as planned. Myelosuppression was mostly grade 1, acute urinary
      injury was mostly grades 1 and 2, and intestinal injury was mostly grade 1. The
      5-year follow-up rate was 91.0%. The overall, progression-free, biochemical
      recurrence-free, and distant metastasis-free survival rates were 82.1%, 79.4%,
      84.6%, and 94.9%, respectively. Tumor volumes defined by small target volumes and
      Radiation Therapy Oncology Group were 274.21 +/- 92.64 and 600.68 +/- 113.72,
      respectively, representing a significant difference (P &lt; .05). Age,
      prostate-specific antigen level, eastern cooperative oncology Group score,
      Gleason score, and volume of CTV were independent risk factors for mortality and 
      disease progression. Our findings indicated that IMRT with reduced CTV have less 
      acute and chronic injuries caused by radiation, particularly grade 3 or higher
      urinary and intestinal injuries, while ensuring survival benefits and protecting 
      the hematopoietic function.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Luo, Hua-Chun
AU  - Luo HC
AD  - Department of Radiation Oncology, Fujian medical university affiliated Fuzhou
      General Hospital.
FAU - Fu, Zhi-Chao
AU  - Fu ZC
AD  - Department of Radiation Oncology, Fujian medical university affiliated Fuzhou
      General Hospital.
FAU - Cheng, Hui-Hua
AU  - Cheng HH
AD  - Department of Radiation Oncology, Fujian medical university affiliated Fuzhou
      General Hospital.
FAU - Lei, Yong
AU  - Lei Y
AD  - Department of Medical, Fuzhou General Hospital of Nanjing Command PLA, Fuzhou.
FAU - Liao, Shao-Guang
AU  - Liao SG
AD  - Department of Radiation Oncology, Fujian medical university affiliated Fuzhou
      General Hospital.
FAU - Feng, Jing
AU  - Feng J
AD  - Department of Radiation Oncology, Fujian medical university affiliated Fuzhou
      General Hospital.
FAU - Yin, Qin
AU  - Yin Q
AD  - Department of Medicine, Longyan Hospital of Traditional Chinese Medicine,
      Longyan.
FAU - Chen, Qun-Hua
AU  - Chen QH
AD  - Department of Medicine, Longyan Hospital of Traditional Chinese Medicine,
      Longyan.
FAU - Lin, Gui-Shan
AU  - Lin GS
AD  - Department of Radiation Oncology, Fujian Province Hospital, Fuzhou.
FAU - Zhu, Jin-Feng
AU  - Zhu JF
AD  - Department of Radiation Oncology, Fujian Province Hospital, Fuzhou.
FAU - Xu, Jian-Feng
AU  - Xu JF
AD  - Department of Urology, Jinjiang Hospital, Quanzhou, China.
FAU - Dian, Wang
AU  - Dian W
AD  - Department of Radiation Oncology, Rush University Medical Center, Chicago, IL.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2018/02/01 06:00
MHDA- 2018/02/01 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/01 06:00 [medline]
AID - 10.1097/MD.0000000000009450 [doi]
AID - 00005792-201712290-00036 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(52):e9450. doi: 10.1097/MD.0000000000009450.