Radiation Oncology (Jul 2012)

Treatment outcome of high-dose image-guided intensity-modulated radiotherapy using intra-prostate fiducial markers for localized prostate cancer at a single institute in Japan

  • Takeda Ken,
  • Takai Yoshihiro,
  • Narazaki Kakutaro,
  • Mitsuya Masatoshi,
  • Umezawa Rei,
  • Kadoya Noriyuki,
  • Fujita Yukio,
  • Sugawara Toshiyuki,
  • Kubozono Masaki,
  • Shimizu Eiji,
  • Abe Keiko,
  • Shirata Yuko,
  • Ishikawa Yohjiro,
  • Yamamoto Takaya,
  • Kozumi Maiko,
  • Dobashi Suguru,
  • Matsushita Haruo,
  • Chida Koichi,
  • Ishidoya Shigeto,
  • Arai Yoichi,
  • Jingu Keiichi,
  • Yamada Shogo

DOI
https://doi.org/10.1186/1748-717X-7-105
Journal volume & issue
Vol. 7, no. 1
p. 105

Abstract

Read online

Abstract Background Several studies have confirmed the advantages of delivering high doses of external beam radiotherapy to achieve optimal tumor-control outcomes in patients with localized prostate cancer. We evaluated the medium-term treatment outcome after high-dose, image-guided intensity-modulated radiotherapy (IMRT) using intra-prostate fiducial markers for clinically localized prostate cancer. Methods In total, 141 patients with localized prostate cancer treated with image-guided IMRT (76 Gy in 13 patients and 80 Gy in 128 patients) between 2003 and 2008 were enrolled in this study. The patients were classified according to the National Comprehensive Cancer Network-defined risk groups. Thirty-six intermediate-risk patients and 105 high-risk patients were included. Androgen-deprivation therapy was performed in 124 patients (88%) for a median of 11 months (range: 2–88 months). Prostate-specific antigen (PSA) relapse was defined according to the Phoenix-definition (i.e., an absolute nadir plus 2 ng/ml dated at the call). The 5-year actuarial PSA relapse-free survival, the 5-year distant metastasis-free survival, the 5-year cause-specific survival (CSS), the 5-year overall survival (OS) outcomes and the acute and late toxicities were analyzed. The toxicity data were scored according to the Common Terminology Criteria for Adverse Events, version 4.0. The median follow-up was 60 months. Results The 5-year PSA relapse-free survival rates were 100% for the intermediate-risk patients and 82.2% for the high-risk patients; the 5-year actuarial distant metastasis-free survival rates were 100% and 95% for the intermediate- and high-risk patients, respectively; the 5-year CSS rates were 100% for both patient subsets; and the 5-year OS rates were 100% and 91.7% for the intermediate- and high-risk patients, respectively. The Gleason score ( Conclusions These medium-term results demonstrate a good tolerance of high-dose image-guided IMRT. However, further follow-up is needed to confirm the long-term treatment outcomes.

Keywords