Intensity-modulated radiation therapy for prostate cancer: late morbidity and results on biochemical control.
OBJECTIVE
To report on late morbidity and biochemical relapse-free survival (bRFS) after intensity-modulated radiation therapy (IMRT) for prostate cancer.


METHODS
Between 1998 and 2005 133 patients were treated with IMRT for T(1-4) N0 M0 prostate cancer. The median follow-up time was 36 months. In a first cohort, patients received a median planning target volume (PTV) dose of 74 Gy with a hard constraint on maximum rectum dose of 72 Gy (74R72, n=51). Later, median PTV and maximum rectum dose were increased to 76 and 74 Gy, respectively (76R74; n=82). We defined low-risk (n=20), intermediate-risk (n=70) and high-risk (n=43) groups. Androgen deprivation was given to patients in the intermediate- and high-risk group. Late gastro-intestinal (GI) and genito-urinary (GU) morbidity and biochemical relapse, in accordance with the ASTRO consensus, were recorded.


RESULTS
We observed grade 2 GI (17%) and GU (19%), grade 3 GI (1%) and GU (3%) late toxicities. Except for hematuria, the median duration of side-effects was 6 months. Biochemical relapse-free survival (bRFS) at 3 and 5 years was 88% and 83%, respectively, with a significantly better 3-year bRSF for the 76R74 than for the 74R72 group (p=0.01). Five-year bRFS for patients in the low-risk, intermediate-risk and high-risk group was 100%, 94% and 74%, respectively (p<0.01).


CONCLUSIONS
IMRT for localized or locally advanced prostate cancer combines low morbidity with excellent biochemical control.
De Meerleer
Gert O
GO
Department of Radiation Therapy, Ghent University Hospital, Gent, Belgium. gert@krtkg1.ugent.be
Fonteyne
Valérie H
VH
Vakaet
Luc
L
Villeirs
Geert M
GM
Denoyette
Ludwig
L
Verbaeys
Antony
A
Lummen
Nicolas
N
De Neve
Wilfried J
WJ
D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009364:Neoplasm Recurrence, Local; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000532:radiotherapy*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D016019:Survival Analysis; D017741:Survivors; D016896:Treatment Outcome
D000726:Androgen Antagonists; D017430:Prostate-Specific Antigen