PURPOSE: To compare acute and late toxicity after three-dimensional conformal radiotherapy to the prostate to 74 Gy (3D-CRT) with intensity-modulated radiotherapy to 78 Gy (IMRT 78) and IMRT using simultaneous integrated boost to 82 Gy (IMRT/SIB 82). PATIENTS AND METHODS: 94 patients treated with 3D-CRT to the prostate and base of seminal vesicles to 74 Gy represented the first group. The second group consisted of 138 patients subjected to IMRT covering the prostate and base of seminal vesicles to 78 Gy. The last group was treated with IMRT using SIB. The prescribed doses were 82 Gy and 73.8 Gy in 42 fractions to the prostate and seminal vesicles. Late toxicity was prospectively scored according to the RTOG/FC-LENT scale. RESULTS: Acute gastrointestinal toxicity >or= grade 2 occurred in 35.1% of patients treated with 3D-CRT, in 16% subjected to IMRT 78, and in 7.7% receiving IMRT/SIB 82. Acute genitourinary toxicity >or= grade 2 was observed in 26.6% (3D-CRT), 33% (IMRT 78), and 30.7% (IMRT/SIB 82). At 3 years, the estimated cumulative incidence of grade 3 late gastrointestinal toxicity was 14% for 3D-CRT, 5% for IMRT 78, and 2% for IMRT/SIB 82. The difference became significant (log rank p = 0.02). The estimated cumulative incidence of grade 3 late genitourinary toxicity was 9% (3D-CRT), 7% (IMRT 78), and 6% (IMRT/SIB 82) without statistical differences (log rank p = 0.32) CONCLUSION: SIB enables dose escalation up to 82 Gy with a lower rate of gastrointestinal toxicity grade 3 in comparison with 3D-CRT up to 74 Gy.

Oncology Center Multiscan and Pardubice Regional Hospital Pardubice Czech Republic

Zobrazit více v PubMed

Strahlenther Onkol. 2006 Apr;182(4):240-6 PubMed

Strahlenther Onkol. 2002 Oct;178(10):542-7 PubMed

Strahlenther Onkol. 2006 Sep;182(9):543-9 PubMed

Strahlenther Onkol. 2005 Mar;181(3):172-8 PubMed

JAMA. 2005 Sep 14;294(10):1233-9 PubMed

Int J Radiat Oncol Biol Phys. 2008 Jan 1;70(1):67-74 PubMed

Strahlenther Onkol. 2004 Mar;180(3):136-43 PubMed

Semin Radiat Oncol. 2008 Jan;18(1):58-66 PubMed

Strahlenther Onkol. 2007 Jun;183(6):307-13 PubMed

J Urol. 2006 Oct;176(4 Pt 1):1415-9 PubMed

Int J Radiat Oncol Biol Phys. 2002 Aug 1;53(5):1097-105 PubMed

Strahlenther Onkol. 2007 Sep;183(9):497-505 PubMed

Int J Radiat Oncol Biol Phys. 2009 Jun 1;74(2):392-8 PubMed

Cancer. 1999 Jun 1;85(11):2460-8 PubMed

Strahlenther Onkol. 2008 Jan;184(1):8-14 PubMed

Int J Radiat Oncol Biol Phys. 2008 Nov 15;72(4):980-8 PubMed

Strahlenther Onkol. 2006 Sep;182(9):537-42 PubMed

Strahlenther Onkol. 2008 Dec;184(12):663-7 PubMed

Neoplasma. 2005;52(2):85-94 PubMed

Int J Radiat Oncol Biol Phys. 2002 Oct 1;54(2):427-35 PubMed

Phys Med. 2005 October - December;21(4):129-35 PubMed

Strahlenther Onkol. 2005 Aug;181(8):483-99 PubMed

Strahlenther Onkol. 2005 Jul;181(7):448-55 PubMed

Semin Radiat Oncol. 2008 Jan;18(1):48-57 PubMed

Int J Radiat Oncol Biol Phys. 2005 Jul 1;62(3):933-9 PubMed

Strahlenther Onkol. 2007 Feb;183(2):57-62 PubMed

Strahlenther Onkol. 2005 Jul;181(7):431-41 PubMed

Int J Radiat Oncol Biol Phys. 1997 Aug 1;39(1):77-83 PubMed

Strahlenther Onkol. 2000 Jan;176(1):3-8 PubMed

Br J Cancer. 2005 Feb 14;92(3):488-98 PubMed

Int J Clin Oncol. 2008 Feb;13(1):48-53 PubMed

Strahlenther Onkol. 2009 Feb;185(2):94-100 PubMed

Int J Radiat Oncol Biol Phys. 1995 Mar 30;31(5):1257-80 PubMed

Strahlenther Onkol. 2008 Dec;184(12):679-85 PubMed

Comparing morbidity and cancer control after 3D-conformal (70/74 Gy) and intensity modulated radiotherapy (78/82 Gy) for prostate cancer

Results of combined radiotherapy and hormonal treatment of prostate cancer patients with initial PSA value >40 ng/ml