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Prostate cancer imrt

Karen E Hoffman, K Ranh Voong, Lawrence B Levy, Pamela K Allen, Seungtaek Choi, Pamela J Schlembach, Andrew K Lee, Sean E McGuire, Quynh Nguyen, Thomas J Pugh, Steven J Frank, Rajat J Kudchadker, Weiliang Du, Deborah A Kuban
Purpose Hypofractionated radiotherapy delivers larger daily doses of radiation and may increase the biologically effective dose delivered to the prostate. We conducted a randomized trial testing the hypothesis that dose-escalated, moderately hypofractionated intensity-modulated radiation therapy (HIMRT) improves prostate cancer control compared with conventionally fractionated IMRT (CIMRT) for men with localized prostate cancer. Patients and Methods Men were randomly assigned to 75.6 Gy in 1.8-Gy fractions delivered over 8...
August 14, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Kiyonao Nakamura, Itaru Ikeda, Haruo Inokuchi, Kenji Takayama, Takahiro Inoue, Tomomi Kamba, Osamu Ogawa, Masahiro Hiraoka, Takashi Mizowaki
The purpose of this pilot study was to evaluate the feasibility of highly hypofractionated intensity-modulated radiation therapy (IMRT) in 15 fractions over 3 weeks for treating localized prostate cancer based on prostate position-based image-guided radiation therapy. Twenty-five patients with National Comprehensive Cancer Network (NCCN) very low- to unfavorable intermediate-risk prostate cancer were enrolled in this study from April 2014 to September 2015 to receive highly hypofractionated IMRT (without intraprostatic fiducial markers) delivering 54 Gy in 15 fractions over 3 weeks...
July 31, 2018: Journal of Radiation Research
Charles C Vu, Kevin G Blas, Thomas B Lanni, Gary S Gustafson, Daniel J Krauss
PURPOSE: The recently published ASCENDE-RT randomized clinical trial demonstrated improved biochemical control, albeit with increased toxicity, for a prostate boost with brachytherapy versus external beam radiation therapy alone in patients with intermediate-high risk prostate cancer. In this study, we investigated the cost-effectiveness of these two modalities in the treatment of intermediate-high risk prostate cancer. METHODS AND MATERIALS: A multistate Markov model was created to model a patient with intermediate-high risk prostate cancer...
July 31, 2018: Brachytherapy
Andre Konski
The use of radiotherapy in the treatment of prostate cancer has evolved from treatments utilizing large fields with hand placed blocks to radiotherapy treatments given with a linear accelerator moving around the patient on a robotic arm. These technologic developments have allowed radiation dose escalations resulting in improvements in disease and patient reported outcomes with longer biochemical disease-free survival (DFS) as well as improved quality of life. Increased costs have accompanied these technologic improvements with some private payers questioning the increased cost of the newer treatments and in some instances refusing to pay for some treatment modalities such as intensity-modulated radiotherapy (IMRT) or proton beam therapy (PBT)...
June 2018: Translational Andrology and Urology
Audrey Dang, Patrick A Kupelian, Minsong Cao, Nzhde Agazaryan, Amar U Kishan
Intensity-modulated radiotherapy (IMRT) has become the standard radiotherapy technology utilized for the treatment of prostate cancer, as it permits the delivery of highly conformal radiation dose distributions. Image-guided radiotherapy (IGRT) is an essential companion to IMRT that allows the treatment team to account for daily changes in target anatomy and positioning. In the present review, we will discuss the different sources of geometric uncertainty and review the rationale behind using IGRT in the treatment of prostate cancer...
June 2018: Translational Andrology and Urology
Ben W Fischer-Valuck, Yuan James Rao, Jeff M Michalski
Radiation therapy (RT) is a curative treatment modality for localized prostate cancer. Over the past two decades, advances in technology and imaging have considerably changed RT in prostate cancer treatment. Treatment has evolved from 2-dimensional (2D) planning using X-ray fields based on pelvic bony landmarks to 3-dimensional (3D) conformal RT (CRT) which uses computed tomography (CT) based planning. Despite improvements with 3D-CRT, dose distributions often remained suboptimal with portions of the rectum and bladder receiving unacceptably high doses...
June 2018: Translational Andrology and Urology
Qiuying Tang, Feng Zhao, Xiaokai Yu, Lingyun Wu, Zhongjie Lu, Senxiang Yan
The delivery of high dose radiotherapy to tumors is often limited by the proximity of the surrounding radiosensitive normal tissues, even using modern techniques such as intensity modulated radiation therapy (IMRT). Previous studies have reported that placement of a spacer can effectively displace normal tissues. So that they are some distance away from the lesion, thus allowing for the safe delivery of high-dose radiation. The application of radioprotective spacers was first reported 30 years ago regarding radiotherapy of tongue and abdominal cancers; more recently, they are increasingly being used in prostate cancer...
June 2018: Quantitative Imaging in Medicine and Surgery
Andrea Galla, Angelo Maggio, Elena Delmastro, Elisabetta Garibaldi, Pietro Gabriele, Sara Bresciani, Amalia Di Dia, Michele Stasi, Domenico Gabriele
BACKGROUND: To evaluate the outcome of patients treated with salvage radiotherapy after radical prostatectomy and to investigate the effects of independent predictors on survival. METHODS: From January 2000 to December 2015, 234 patients with biochemical/clinical recurrences after radical prostatectomy were submitted to salvage radiotherapy(SRT). 157 patients (67%) received three-dimensional (3D) conformal radiotherapy while 77 patients (33%) were treated with IMRT or IMRT/IGRT by Tomotherapy...
July 23, 2018: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Tubin Slavisa, Raunik Wolfgang
Currently, there are no specific recommendations regarding the management of the synchronous tumours due to the lack of either specific guidelines or individuals' clinical experiences relative to these clinical situations. In the presence of a locally advanced double primary tumour and with the lymph node metastases in addition, from the radiotherapeutical point of view, it must be challenging to manage this complicated situation that requires a more delicate treatment planning, due to higher doses prescribed to greater volumes concomitantly with the chemotherapy...
2018: Case Reports in Oncological Medicine
Curtiland Deville, Akansha Jain, Wei-Ting Hwang, Kristina D Woodhouse, Stefan Both, Shiyu Wang, Peter E Gabriel, John P Christodouleas, Justin Bekelman, Zelig Tochner, Neha Vapiwala
PURPOSE: To report acute and late genitourinary (GU) and gastrointestinal (GI) toxicities associated with post-prostatectomy proton therapy (PT). METHODS: The first 100 consecutive patients from 2010 to 2016 were retrospectively assessed. Baseline characteristics, prospectively graded CTCAE v4.0 toxicities, and patient-reported outcomes were reported. Late outcomes were reported for 79 patients with 3 months minimum follow up. Toxicity-free survival Kaplan-Meier curves were estimated...
July 20, 2018: Acta Oncologica
Kazuki Kotabe, Hidetsugu Nakayama, Aruga Takashi, Atsuko Takahashi, Tsuyoshi Tajima, Haruki Kume
The association between rectal bleeding and the received dose relative to the volume of the rectum is well established in prostate cancer patients who have undergone radiotherapy. The relative volume of the rectum is affected by the rectal anatomical volume, which depends on the definition of rectal length. Compared with the relative rectal volume, the absolute volume of the rectum may be more associated with rectal bleeding. The present study investigated the absolute volume of the rectum that may be used to predict late rectal bleeding following intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT)...
August 2018: Oncology Letters
Yuka Hayama, Hiroshi Doi, Tae Hasegawa, Yumi Minami, Noriko Ichimura, Mariko Koike, Hiroya Shiomi, Ryoong-Jin Oh, Fumiko Oishi
OBJECTIVE: The aim of the present study was to collect data on the characteristics, degree, and natural course of urinary complications, as well as self-care for such complications, in patients during and after prostate intensity-modulated radiation therapy (IMRT). METHODS: Quality of life data were collected retrospectively for all eligible patients who underwent IMRT. In all eligible patients, urinary symptoms were evaluated using questionnaires and face-to-face interview...
July 16, 2018: Lower Urinary Tract Symptoms
Nabila L Waheed, Alison K Yoder, Renae D Van Wyhe, Steven L Carpenter
With 222,500 new cases estimated for 2017, prostate cancer makes up approximately 10% of all new cancer diagnoses in the United States and is the third most common cancer after breast and lung cancer. In 2013, the American Society of Radiation Oncology (ASTRO) policy model recognized that stereotactic body radiation therapy (SBRT) may be used as an alternative to standard treatment modalities, i.e. intensity modulated radiation therapy (IMRT), to treat prostate cancer. In this study, we report outcomes for a cohort of 30 patients with prostate cancer treated with SBRT at our institution...
May 8, 2018: Curēus
Takuji Tsubokura, Hideya Yamazaki, Koji Masui, Naomi Sasaki, Daisuke Shimizu, Gen Suzuki, Satoaki Nakamura, Kei Yamada, Koji Okihara, Takumi Shiraishi, Ken Yoshida, Tatsuyuki Nishikawa, Haruumi Okabe
To compare the outcome of low-dose rate brachytherapy (LDR-BT) and image-guided intensity-modulated radiotherapy (IG-IMRT) for localized prostate cancer, we examined 488 LDR-BT and 269 IG-IMRT patients. IG-IMRT treated older and advanced disease with more hormonal therapy than LDR-BT, which excluded T3b-T4 tumor and initial PSA > 50 ng/ml. The actuarial five-year biochemical failure-free survival rate was 88.7% and 96.7% (p = 0.0003) in IG-IMRT and LDR-BT, respectively; it was 88.2% (85.1% for IG-IMRT and 94...
July 12, 2018: Scientific Reports
Li Rebekah Feng, Simeng Suy, Sean P Collins, Jonathan W Lischalk, Berwin Yuan, Leorey N Saligan
Background: Prostate cancer survivors commonly experience late-onset lower urinary tract symptoms following radiotherapy. We aimed to compare lower urinary tract symptoms in patients treated with stereotactic body radiotherapy (SBRT) to those treated with a combination of lower dose SBRT and supplemental intensity-modulated radiotherapy (SBRT + IMRT). Methods: Subjects with localized prostate carcinoma scheduled to receive SBRT or a combination of SBRT and IMRT were enrolled and followed for up to 2 years after treatment completion...
June 2018: Current Urology
Fan-Tu Kong, Yan-Hua Mai, Meng-Ke Qi, Ai-Qian Wu, Fu-Tong Guo, Qi-Yuan Jia, Yong-Bao Li, Ting Song, Ling-Hong Zhou
OBJECTIVE: To establish the association between the geometric anatomical characteristics of the patients and the corresponding three-dimensional (3D) dose distribution of radiotherapy plan via feed-forward back-propagation neural network for clinical prediction of the plan dosimetric features. METHODS: A total of 25 fixed 13-field clinical prostate cancer intensity-modulated radiation therapy (IMRT)/stereotactic body radiation therapy (SBRT) plans were collected with a prescribed dose of 50 Gy...
June 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Ann H Klopp, Anamaria R Yeung, Snehal Deshmukh, Karen M Gil, Lari Wenzel, Shannon N Westin, Kent Gifford, David K Gaffney, William Small, Spencer Thompson, Desiree E Doncals, Guilherme H C Cantuaria, Brian P Yaremko, Amy Chang, Vijayananda Kundapur, Dasarahally S Mohan, Michael L Haas, Yong Bae Kim, Catherine L Ferguson, Stephanie L Pugh, Lisa A Kachnic, Deborah W Bruner
Purpose NRG Oncology/RTOG 1203 was designed to compare patient-reported acute toxicity and health-related quality of life during treatment with standard pelvic radiation or intensity-modulated radiation therapy (IMRT) in women with cervical and endometrial cancer. Methods Patients were randomly assigned to standard four-field radiation therapy (RT) or IMRT radiation treatment. The primary end point was change in patient-reported acute GI toxicity from baseline to the end of RT, measured with the bowel domain of the Expanded Prostate Cancer Index Composite (EPIC)...
July 10, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Keisuke Tamari, Ryoong-Jin Oh, Norihisa Masai, Hiroya Shiomi, Keisuke Otani, Osamu Suzuki, Kazuhiko Ogawa
BACKGROUND/AIM: The long-term efficacy and safety of moderately hypofractionated intensity-modulated radiation therapy (MH-IMRT) in prostate cancer remains uncertain. This study aimed to evaluate MH-IMRT regimen of 72 Gy in 30 fractions in patients with prostate cancer. PATIENTS AND METHODS: The outcomes of 412 consecutive prostate cancer patients, who received MH-IMRT between May 2007 and December 2012, were retrospectively reviewed. The median patient age was 70...
July 2018: Anticancer Research
Alessandro Cicchetti, Barbara Avuzzi, Federica Palorini, Francesca Ballarini, Claudio Stucchi, Giovanni Fellin, Pietro Gabriele, Vittorio Vavassori, Claudio Degli Esposti, Cesare Cozzarini, Claudio Fiorino, Tiziana Rancati, Riccardo Valdagni
PURPOSE: This study aimed to validate a previously published predictive model for late fecal incontinence (FI) in a contemporary population of prostate cancer patients treated with radical radiation therapy. METHODS AND MATERIALS: The validation included patients treated with intensity-modulated radiation therapy (IMRT) (2010-2014). Prescribed dose range was 65-80 Gy, including conventional and moderate hypo-fractionated treatments. Rectal toxicity was scored using LENT/SOMA, a minimum 2-year follow up was considered...
June 30, 2018: International Journal of Radiation Oncology, Biology, Physics
Hamid Abdollahi, Seied Rabi Mahdavi, Bahram Mofid, Mohsen Bakhshandeh, Abolfazl Razzaghdoust, Afshin Sadipour, Kiarash Tanha
PURPOSE: To investigate MRI radiomic analysis to assess IMRT associated rectal wall changes and also for predicting radiotherapy induced rectal toxicity. MATERIAL AND METHODS: At first, a machine learning radiomic analysis was applied on T2 weighted (T2W) and apparent diffusion coefficient (ADC) rectal wall MR images of prostate cancer patients' pre and post-IMRT to predict rectal toxicity. Next, Wilcoxon singed rank-test was performed to find radiomic features with significant changes pre-post-IMRT...
July 3, 2018: International Journal of Radiation Biology
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