High-dose (80 Gy) intensity-modulated radiation therapy with daily image-guidance as primary treatment for localized prostate cancer.
OBJECTIVE
to report acute and late toxicity in prostate cancer patients treated by high-dose intensity-modulated radiation therapy (IMRT) with daily image-guidance.


METHODS
from 06/2004-03/2008, 102 men were treated with 80 Gy IMRT with daily image-guidance. The risk groups were as follows: low, intermediate, and high risk in 21%, 27%, and 52% of patients, respectively. Hormone therapy was given to 65% of patients. Toxicity was scored according to the CTC scale version 3.0.


RESULTS
median age was 69 years and median follow-up was 39 months (range, 16-61 months). Acute and late grade 2 gastrointestinal (GI) toxicity occurred in 2% and 5% of patients, respectively, while acute and late grade 3 GI toxicity was absent. Grade 2 and 3 pretreatment genitourinary (GU) morbidity (PGUM) were 15% and 2%, respectively. Acute grade 2 and 3 GU toxicity were 43% and 5% and late grade 2 and 3 GU toxicity were 21% and 1%, respectively. After multiple Cox regression analysis, PGUM was an independent predictor of decreased late ≥ grade 2 GU toxicity-free survival (hazard ratio = 9.4 (95% confidence interval: 4.1, 22.0), p < 0.001). At the end of follow-up, the incidence of late grade 2 and 3 GU toxicity decreased to 7% and 1%, respectively.


CONCLUSIONS
GI toxicity rates after IMRT with daily image-guidance were excellent. GU toxicity rates were acceptable and strongly related to PGUM.
Department of Radiation Oncology with Division of Medical Radiation Physics, Inselspital, University Hospital, and University of Bern, Bern, Switzerland.
Pirus
P
Ghadjar
Nicole
N
Gwerder
Peter
P
Manser
Jacqueline
J
Vock
Axel
A
Madlung
Roberto
R
Mini
Daniel M
DM
Aebersold
D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D011832:Radiation Injuries / Q000209:etiology*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D011881:Radiotherapy, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated; D020728:Transurethral Resection of Prostate; D014566:Urogenital System / Q000528:radiation effects*
D018931:Antineoplastic Agents, Hormonal