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. 2011 Sep 1;3(3):3419-31.
doi: 10.3390/cancers3033419.

Toxicity and Long-Term Outcomes of Dose-Escalated Intensity Modulated Radiation Therapy to 74Gy for Localised Prostate Cancer in a Single Australian Centre

Joseph Sia  1 , Daryl Lim Joon, Angela Viotto, Carmel Mantle, George Quong, Aldo Rolfo, Morikatsu Wada, Nigel Anderson, Maureen Rolfo, Vincent Khoo
Affiliations

Toxicity and Long-Term Outcomes of Dose-Escalated Intensity Modulated Radiation Therapy to 74Gy for Localised Prostate Cancer in a Single Australian Centre

Joseph Sia et al. Cancers (Basel). .

Abstract

Purpose: To report the toxicity and long-term outcomes of dose-escalated intensity-modulated radiation therapy (IMRT) for patients with localised prostate cancer.

Methods and materials: From 2001 to 2005, a total of 125 patients with histologically confirmed T1-3N0M0 prostate cancer were treated with IMRT to 74Gy at the Austin Health Radiation Oncology Centre. The median follow-up was 5.5 years (range 0.5-8.9 years). Biochemical prostate specific antigen (bPSA) failure was defined according to the Phoenix consensus definition (absolute nadir + 2ng/mL). Toxicity was scored according to the RTOG/EORTC criteria. Kaplan-Meier analysis was used to calculate toxicity rates, as well as the risks of bPSA failure, distant metastases, disease-specific and overall survival, at 5 and 8-years post treatment.

Results: All patients completed radiotherapy without any treatment breaks. The 8-year risks of ≥ Grade 2 genitourinary (GU) and gastrointestinal (GI) toxicity were 6.4% and 5.8% respectively, and the 8-year risks of ≥ Grade 3 GU and GI toxicity were both < 0.05%. The 5 and 8-year freedom from bPSA failure were 76% and 58% respectively. Disease-specific survival at 5 and 8 years were 95% and 91%, respectively, and overall survival at 5 and 8 years were 90% and 71%, respectively.

Conclusions: These results confirm existing international data regarding the safety and efficacy of dose-escalated intensity-modulated radiation therapy for localised prostate cancer within an Australian setting.

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Figures

Figure 1.
Figure 1.
Intensity modulated radiation therapy (IMRT) planning for a typical prostate case.
Figure 2.
Figure 2.
Crude incidences of acute genitourinary (GU) and gastrointestinal (GI) toxicity.
Figure 3.
Figure 3.
Crude incidences of late genitourinary (GU) and gastrointestinal (GI) toxicity.
Figure 4.
Figure 4.
Freedom from ≥ Grade 2 late genitourinary (GU) and gastrointestinal (GI) toxicity.
Figure 5.
Figure 5.
Freedom from biochemical PSA failure for the low and intermediate risk groups, high and very high risk groups, and the entire cohort according to the Phoenix consensus definition
Figure 6.
Figure 6.
Freedom from distant metastases for the entire cohort.
Figure 7.
Figure 7.
Disease-specific survival and overall survival for the entire cohort.
See this image and copyright information in PMC

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