Feasibility and safety of definite volumetric modulated arc therapy with simultaneous integrated boost to the dominant intraprostatic lesion in patients with unfavorable intermediate to high-risk prostate cancer
Issued Date
2022-01-01
Resource Type
ISSN
15071367
Scopus ID
2-s2.0-85131103607
Journal Title
Reports of Practical Oncology and Radiotherapy
Volume
27
Issue
2
Start Page
260
End Page
267
Rights Holder(s)
SCOPUS
Bibliographic Citation
Reports of Practical Oncology and Radiotherapy Vol.27 No.2 (2022) , 260-267
Suggested Citation
Dankulchai P. Feasibility and safety of definite volumetric modulated arc therapy with simultaneous integrated boost to the dominant intraprostatic lesion in patients with unfavorable intermediate to high-risk prostate cancer. Reports of Practical Oncology and Radiotherapy Vol.27 No.2 (2022) , 260-267. 267. doi:10.5603/rpOr.a2022.0041 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86532
Title
Feasibility and safety of definite volumetric modulated arc therapy with simultaneous integrated boost to the dominant intraprostatic lesion in patients with unfavorable intermediate to high-risk prostate cancer
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Background: The most common site of recurrence of prostate cancer after definite radiation therapy is the dominant intraprostatic lesion (DIL). This study aimed to investigate the feasibility and safety of definite volumetric modulated arc therapy (VMAT) with simultaneous integrated boost (SIB) to the DIL in patients with unfavorable intermediate to high-risk prostate cancer. Materials and methods: In this prospective uncontrolled clinical trial, patients were delivered VMAT at a dose of 87.75 Gy in 39 fractions or 70 Gy in 20 fractions to the DIL in combination with androgen deprivation therapy. Genitourinary (GU) and rectal toxicity, International Prostate Symptom Score (IPSS) and IPSS quality of life (IPSS-QOL) score were collected. Results: Forty-five patients with a median follow-up of 20 months were analyzed. The cumulative incidence of acute grade ≥ 2 GU and rectal toxicity was 33.1% and 9.5%, respectively. Regarding late toxicity, the cumulative incidence of grade ≥ 2 GU and rectal toxicity was 12.6% and 2.8%, respectively. During treatment, the mean increase of IPSS was +7.4 ± 4.2 and the mean increase of IPSS-QOL was +1.7 ± 1.3. However, both IPSS and IPSS-QOL scores returned to their baseline levels by 3-months post-treatment. No significant correlation between baseline characteristics and grade ≥ 2 GU or rectal toxicity was found. Conclusion: Focal SIB to the DIL of ≥ 90 Gy EQD2 in unfavorable intermediate to high-risk prostate cancer patients resulted in tolerable toxicity profiles. The mean IPSS and IPSS-QOL scores both worsened during treatment; however, both scores returned to baseline level by 3 months after treatment.