User login
Purpose: It is conventional to treat pelvic lymph nodes, followed by prostate boost in a sequential manner, requiring 8-9 weeks to complete therapy. In the last several years there have been several randomized studies of implementing moderate hypofractionated radiotherapy in prostate cancer to shorten the treatment time, which has proven to be non-inferior to conventional treatment. The purpose of this retrospective study is to evaluate the acute toxicities of hypofractionated SIB radiotherapy in treating the lymph nodes with prostate boost.
Methods: Between 2015 and 2017, twenty five high risk prostate cancer patients received pelvic node radiotherapy with prostate boost in 25 fractions with SIB technique with neo-adjuvant and concurrent hormone therapy to 50 Gy/25 fractions at 2 Gy/fraction to pelvic nodes and prostate boost for a total of 67.5 - 75 Gy at 2.7 to 3.0 Gy/fraction. We followed QUNTAC dose-volume constraints for the rectum, bladder and bowel. All these patients received long-term hormone therapy.
Results: The median age was 66 years (range 57-81 years). There were 6 stage II C, 7 III A, 15 III C, and 1 stage IV A. All patients were restaged as per American Joint Committee on Cancer 8th edition. Gleason Score: 6 (1), 7 (4+3) (4), 8 (5), and 9-10 (15). The average PSA was 17.2 ng/mL with a range of 5.6 to 51.92 ng/mL, and average number of positive cores was 74%. These factors put the majority of patients into the very high risk group. The median follow up was 24 months. The majority of the patients tolerated treatment well. Grade 0 genitourinary (GU) toxicity occurred
in 8 (33%) patients, grade II 16 (67%) patients, one patient had a Foley catheter during treatment, a majority of patients were on alpha blockers either before, during or post radiotherapy. Grade 0 gastrointestinal (GI) toxicity occurred in 21 (84%) patients, grade 1 in one, and grade II in 3 (12%) patients. There were no grade 3 or 4 GU or GI toxicities.
Conclusions: Simultaneous integrated boost with VMAT is well tolerated in treating pelvic nodes and prostate boost, without any major acute toxicities. This technique is used in mostly for very high risk localized prostate cancer patients, reducing number of fractions from conventional sequential treatment.
Purpose: It is conventional to treat pelvic lymph nodes, followed by prostate boost in a sequential manner, requiring 8-9 weeks to complete therapy. In the last several years there have been several randomized studies of implementing moderate hypofractionated radiotherapy in prostate cancer to shorten the treatment time, which has proven to be non-inferior to conventional treatment. The purpose of this retrospective study is to evaluate the acute toxicities of hypofractionated SIB radiotherapy in treating the lymph nodes with prostate boost.
Methods: Between 2015 and 2017, twenty five high risk prostate cancer patients received pelvic node radiotherapy with prostate boost in 25 fractions with SIB technique with neo-adjuvant and concurrent hormone therapy to 50 Gy/25 fractions at 2 Gy/fraction to pelvic nodes and prostate boost for a total of 67.5 - 75 Gy at 2.7 to 3.0 Gy/fraction. We followed QUNTAC dose-volume constraints for the rectum, bladder and bowel. All these patients received long-term hormone therapy.
Results: The median age was 66 years (range 57-81 years). There were 6 stage II C, 7 III A, 15 III C, and 1 stage IV A. All patients were restaged as per American Joint Committee on Cancer 8th edition. Gleason Score: 6 (1), 7 (4+3) (4), 8 (5), and 9-10 (15). The average PSA was 17.2 ng/mL with a range of 5.6 to 51.92 ng/mL, and average number of positive cores was 74%. These factors put the majority of patients into the very high risk group. The median follow up was 24 months. The majority of the patients tolerated treatment well. Grade 0 genitourinary (GU) toxicity occurred
in 8 (33%) patients, grade II 16 (67%) patients, one patient had a Foley catheter during treatment, a majority of patients were on alpha blockers either before, during or post radiotherapy. Grade 0 gastrointestinal (GI) toxicity occurred in 21 (84%) patients, grade 1 in one, and grade II in 3 (12%) patients. There were no grade 3 or 4 GU or GI toxicities.
Conclusions: Simultaneous integrated boost with VMAT is well tolerated in treating pelvic nodes and prostate boost, without any major acute toxicities. This technique is used in mostly for very high risk localized prostate cancer patients, reducing number of fractions from conventional sequential treatment.
Purpose: It is conventional to treat pelvic lymph nodes, followed by prostate boost in a sequential manner, requiring 8-9 weeks to complete therapy. In the last several years there have been several randomized studies of implementing moderate hypofractionated radiotherapy in prostate cancer to shorten the treatment time, which has proven to be non-inferior to conventional treatment. The purpose of this retrospective study is to evaluate the acute toxicities of hypofractionated SIB radiotherapy in treating the lymph nodes with prostate boost.
Methods: Between 2015 and 2017, twenty five high risk prostate cancer patients received pelvic node radiotherapy with prostate boost in 25 fractions with SIB technique with neo-adjuvant and concurrent hormone therapy to 50 Gy/25 fractions at 2 Gy/fraction to pelvic nodes and prostate boost for a total of 67.5 - 75 Gy at 2.7 to 3.0 Gy/fraction. We followed QUNTAC dose-volume constraints for the rectum, bladder and bowel. All these patients received long-term hormone therapy.
Results: The median age was 66 years (range 57-81 years). There were 6 stage II C, 7 III A, 15 III C, and 1 stage IV A. All patients were restaged as per American Joint Committee on Cancer 8th edition. Gleason Score: 6 (1), 7 (4+3) (4), 8 (5), and 9-10 (15). The average PSA was 17.2 ng/mL with a range of 5.6 to 51.92 ng/mL, and average number of positive cores was 74%. These factors put the majority of patients into the very high risk group. The median follow up was 24 months. The majority of the patients tolerated treatment well. Grade 0 genitourinary (GU) toxicity occurred
in 8 (33%) patients, grade II 16 (67%) patients, one patient had a Foley catheter during treatment, a majority of patients were on alpha blockers either before, during or post radiotherapy. Grade 0 gastrointestinal (GI) toxicity occurred in 21 (84%) patients, grade 1 in one, and grade II in 3 (12%) patients. There were no grade 3 or 4 GU or GI toxicities.
Conclusions: Simultaneous integrated boost with VMAT is well tolerated in treating pelvic nodes and prostate boost, without any major acute toxicities. This technique is used in mostly for very high risk localized prostate cancer patients, reducing number of fractions from conventional sequential treatment.