Long-Term Outcome of High Dose Intensity Modulated Radiation Therapy for Patients With Clinically Localized Prostate Cancer

Abstract

No AccessJournal of UrologyAdult urology1 Oct 2006Long-Term Outcome of High Dose Intensity Modulated Radiation Therapy for Patients With Clinically Localized Prostate Cancer Michael J. Zelefsky, Heather Chan, Margie Hunt, Yoshiya Yamada, Alison M. Shippy, and Howard Amols Michael J. ZelefskyMichael J. Zelefsky Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York Nothing to disclose. More articles by this author , Heather ChanHeather Chan Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York Nothing to disclose. More articles by this author , Margie HuntMargie Hunt Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York Nothing to disclose. More articles by this author , Yoshiya YamadaYoshiya Yamada Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York Financial interest and/or other relationship with Varian Medical. More articles by this author , Alison M. ShippyAlison M. Shippy Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York Nothing to disclose. More articles by this author , and Howard AmolsHoward Amols Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York Nothing to disclose. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2006.06.002AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We report on the long-term results and late toxicity outcomes of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer. Materials and Methods: Between 1996 and 2000 a total of 561 patients with clinically localized prostate cancer were treated with intensity modulated radiation therapy. All patients were treated to a dose of 81 Gy prescribed to the planning target volume. Prostate specific antigen relapse was defined according to the American Society for Therapeutic Radiology and Oncology consensus and Houston definitions (absolute nadir plus 2 ng/ml dated at the call). Median followup was 7 years (range 5 to 9). Results: The 8-year actuarial PSA relapse-free survival rates for patients in favorable, intermediate and unfavorable risk groups according to the American Society for Therapeutic Radiology and Oncology definition were 85%, 76% and 72%, respectively (p <0.025). The 8-year actuarial prostate specific antigen relapse-free survival rates for patients in favorable, intermediate and unfavorable risk groups according to the Houston definition were 89%, 78% and 67%, respectively (p = 0.0004). The 8-year actuarial likelihood of grade 2 rectal bleeding was 1.6%. Three patients (0.1%) experienced grade 3 rectal toxicity requiring either 1 or more transfusions or a laser cauterization procedure. No grade 4 rectal complications have been observed. The 8-year likelihood of late grade 2 and 3 (urethral strictures) urinary toxicities were 9% and 3%, respectively. Among patients who were potent before intensity modulated radiation therapy, erectile dysfunction developed in 49%. The cause specific survival outcomes for favorable, intermediate and unfavorable risk cases were 100%, 96% and 84%, respectively. Conclusions: These long-term results confirm our previous observations regarding the safety of high dose intensity modulated radiation therapy for clinically localized prostate cancer. Despite the application of high radiation doses, the incidence of rectal bleeding at 8 years was less than 2%. 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Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited byTurchan W, Cutright D, Wu T, Leng J, Dignam J, Eggener S and Liauw S (2022) Hematuria following Post-Prostatectomy Radiotherapy: Incidence Increases with Long-Term FollowupJournal of Urology, VOL. 207, NO. 6, (1236-1245), Online publication date: 1-Jun-2022.Zelefsky M, Goldman D, Reuter V, Kollmeier M, McBride S, Zhang Z, Varghese M, Pei X and Fuks Z (2019) Long-Term Implications of a Positive Posttreatment Biopsy in Patients Treated with External Beam Radiotherapy for Clinically Localized Prostate CancerJournal of Urology, VOL. 201, NO. 6, (1127-1133), Online publication date: 1-Jun-2019.Griebling T (2016) Re: Clinical Outcomes of Helical Tomotherapy for Super-Elderly Patients with Localized and Locally Advanced Prostate Cancer: Comparison with Patients under 80 Years of AgeJournal of Urology, VOL. 196, NO. 1, (107-107), Online publication date: 1-Jul-2016.Zumsteg Z, Spratt D, Romesser P, Pei X, Zhang Z, Kollmeier M, McBride S, Yamada Y and Zelefsky M (2015) Anatomical Patterns of Recurrence Following Biochemical Relapse in the Dose Escalation Era of External Beam Radiotherapy for Prostate CancerJournal of Urology, VOL. 194, NO. 6, (1624-1630), Online publication date: 1-Dec-2015.Khanna A, Hu J, Gu X, Nguyen P, Lipsitz S and Palapattu G (2012) Certificate of Need Programs, Intensity Modulated Radiation Therapy Use and the Cost of Prostate Cancer CareJournal of Urology, VOL. 189, NO. 1, (75-79), Online publication date: 1-Jan-2013.Elliott S, Adejoro O, Konety B, Jarosek S, Dusenbery K and Virnig B (2012) Intensity Modulated Radiation Therapy Replaces 3-Dimensional Conformal Radiotherapy as Prostate Cancer TreatmentJournal of Urology, VOL. 187, NO. 4, (1253-1258), Online publication date: 1-Apr-2012.Kapoor D, Zimberg S, Ohrin L, Underwood W and Olsson C (2011) Utilization Trends in Prostate Cancer TherapyJournal of Urology, VOL. 186, NO. 3, (860-864), Online publication date: 1-Sep-2011. Volume 176Issue 4October 2006Page: 1415-1419 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsprostatic neoplasmsintensity-modulatedradiotherapytoxicityMetricsAuthor Information Michael J. Zelefsky Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York Nothing to disclose. More articles by this author Heather Chan Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York Nothing to disclose. More articles by this author Margie Hunt Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York Nothing to disclose. More articles by this author Yoshiya Yamada Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York Financial interest and/or other relationship with Varian Medical. More articles by this author Alison M. Shippy Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York Nothing to disclose. More articles by this author Howard Amols Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York Nothing to disclose. More articles by this author Expand All Advertisement PDF downloadLoading ...