Histopathologic effects of hypofractionated robotic radiation therapy on malignant and benign prostate tissue.
We describe the first histopathologic analysis of prostatic tissue following hypofractionated robotic radiation therapy. A 66 year-old man presented with stage II, low risk adenocarcinoma of the prostate and underwent elective conformal hypofractionated radiation therapy. His pretreatment evaluation revealed T1c adenocarcinoma, Gleason's grade 3 + 3 = 6 and a prostate specific antigen (PSA) level of 4.87 ng/ml. Hypofractionated radiation therapy (37.5 Gy in five daily fractions of 7.5 Gy) was completed on an Internal Review Board approved protocol. One year later, he developed progressive urinary retention. Transurethral prostatic resection was performed to alleviate obstructive symptoms. Bilobar hypertrophy was observed without evidence of stricture. Histolopathologic analyses of resected prostate tissues revealed changes consistent with radiation treatment, including cellular changes, inflammation, glandular atrophy and hyperplasia. There was no evidence of residual cancer, fibrosis or necrosis. The patient's postoperative course was uneventful with post-treatment PSA of 0.5 ng/ml and residual grade 1 stress incontinence.
Department of Radiation Medicine, Georgetown University Hospital.
Simeng
S
Suy
Eric
E
Oermann
Heather
H
Hanscom
Sue
S
Lei
Saloomeh
S
Vahdat
Xia
X
Yu
Hyeon U
HU
Park
Viola
V
Chen
Brian T
BT
Collins
Kevin
K
McGeagh
Nancy
N
Dawson
Reena
R
Jha
Norio
N
Azumi
Anatoly
A
Dritschilo
John
J
Lynch
Sean P
SP
Collins
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D001706:Biopsy; D019583:Dose Fractionation, Radiation; D006801:Humans; D008297:Male; D011467:Prostate / Q000473:pathology* / Q000528:radiation effects*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D012371:Robotics