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Titolo:
Short-course intensity-modulated radiotherapy for localized prostate cancer with daily transabdominal ultrasound localization of the prostate gland
Autore:
Mohan, DS; Kupelian, PA; Willoughby, TR;
Indirizzi:
Cleveland Clin Fdn, Dept Radiat Oncol, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 Oncol, Cleveland, OH 44195 USA
Titolo Testata:
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
fascicolo: 3, volume: 46, anno: 2000,
pagine: 575 - 580
SICI:
0360-3016(20000201)46:3<575:SIRFLP>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONFORMAL RADIATION-THERAPY; EXTERNAL-BEAM RADIOTHERAPY; DOSE-ESCALATION; SEMINAL-VESICLES; ORGAN MOTION; POSITION; MARKERS;
Keywords:
prostatic neoplasms; local therapy; radiotherapy; intensity-modulation; toxicity;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Kupelian, PA Cleveland Clin Fdn, Dept Radiat Oncol, Desk T28,9500 Euclid Ave, Cleveland, OH 44195 USA Cleveland Clin Fdn Desk T28,9500 Euclid Ave Cleveland OH USA 44195
Citazione:
D.S. Mohan et al., "Short-course intensity-modulated radiotherapy for localized prostate cancer with daily transabdominal ultrasound localization of the prostate gland", INT J RAD O, 46(3), 2000, pp. 575-580

Abstract

modulated radiotherapy (SCIM-RT) in the treatment of localized prostate cancer coupled with daily transabdominal ultrasound localization of the prostate. The proposed regimen consists of a hypofractionated course delivering 70.0 Gy in 28 fractions. Methods and Materials: The treatment data of the first 51 patients treatedwith SCLM-RT at the Cleveland Clinic Foundation are presented in this report. The technique consisted of intensity-modulated radiotherapy using 5 static fields (anterior, 2 laterals, and 2 anterior obliques). Inverse plans were generated by the Corvus treatment-planning system. The treatment delivery was performed with a Varian Dynamic Multileaf Collimator. The target wasthe prostate only in patients with low-risk disease (stage T1-T2, pretreatment PSA less than or equal to 10, and biopsy Gleason less than or equal to6). The target was the prostate and seminal vesicles in patients with high-risk disease (stage T3 or pretreatment PSA >10 or biopsy Gleason greater than or equal to 7). In the Corvus planning system, the margins for the planning target volume (PTV) were 4 mm posteriorly, 8 mm laterally, and 5 mm inall other directions. A total of 70.0 Gy (mean prostate dose approximately75 Gy) was prescribed in all cases at 25 Gy per fraction to be delivered in 28 fractions over 51/2 weeks. Prior to treatment delivery, the patients were minimally immobilized on the treatment table, only using lasers and skin marks. The location of the prostate gland was verified daily with the BATtransabdominal ultrasound system and patient position adjustments were performed accordingly. Fifty-one patients completed therapy between October 1998 and May 1999. Results: The dose was prescribed to an isodose line ranging from 82.0% to 90.0% (mean: 87.2%). The range of the individual prostate mean doses was 73.5 to 78.5 Gy (average: 753 Gy). The range of the maximum doses was 77.4 to84.5 Gy (average: 80.2 Gy). The range of the minimum doses was 64.3 to 69.2 Gy (average: 67.5 Gy). The average time for the prostate position verification and alignment of the prostate using the BAT system was 5 minutes. Theentire localization/alignment process was performed by the radiation therapists. The daily alignment images were automatically saved and reviewed by the radiation oncologist, a process similar to port film checks. The total treatment (beam-on) time was around 6 minutes using the 5 static intensity-modulated fields. The mean and standard deviation (SD) of bladder volumes irradiated to 50, 60, and 70 Gy were as follows: 24 +/- II cc, 16 +/- 8 cc, and 8 +/- 6 cc. The mean and SD of rectal volumes irradiated to 50, 60, and70 Gy were as follows: 22 +/- 11 cc, 15 +/- 8 cc, and 7 +/- 5 cc. The RTOGacute bladder toxicity scores were as follows: 0 in 3 (6%), 1 in 38 (74%),and 2 in 10 (20%). The RTOG acute rectal toxicity scores for SCIM-RT caseswere as follows: 0 in 10 (20%), 1 in 33 (65%), and 2 in 8 (16%). No Grade 3 or 4 acute toxicities were observed. Conclusion: The delivery of our proposed hypofractionated-sehedule SCLM-RTin combination with daily target localization/alignment with the BAT transabdominal ultrasound system is clinically feasible. It is an alternative method of dose escalation in the treatment of localized prostate cancer. The proposed schedule would significantly increase convenience to patients due to the decrease in overall treatment time. Preliminary acute toxicity results are extremely encouraging. Long-term follow-up is needed to assess late complications and treatment efficacy. (C) 2000 Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/04/20 alle ore 14:50:13