title: Outcome and toxicity for patients treated with intensity modulated radiation therapy for localized prostate cancer.
abstract: OBJECTIVE
  We evaluate long-term disease control and chronic toxicities observed in patients treated with intensity modulated radiation therapy for clinically localized prostate cancer.
  
  
  METHODS
  A total of 302 patients with localized prostate cancer treated with image guided intensity modulated radiation therapy between July 2000 and May 2005 were retrospectively analyzed. Risk groups (low, intermediate and high) were designated based on National Comprehensive Cancer Network guidelines. Biochemical control was based on the American Society for Therapeutic Radiology and Oncology (Phoenix) consensus definition. Chronic toxicity was measured at peak symptoms and at last visit. Toxicity was scored based on Common Terminology Criteria for Adverse Events v4.
  
  
  RESULTS
  The median radiation dose delivered was 75.6 Gy (range 70.2 to 77.4) and 35.4% of patients received androgen deprivation therapy. Patients were followed until death or from 6 to 138 months (median 91) for those alive at last evaluation. Local and distant recurrence rates were 5% and 8.6%, respectively. At 9 years biochemical control rates were 77.4% for low risk, 69.6% for intermediate risk and 53.3% for high risk cases (log rank p = 0.05). On multivariate analysis T stage and prostate specific antigen group were prognostic for biochemical control. At last followup only 0% and 0.7% of patients had persistent grade 3 or greater gastrointestinal and genitourinary toxicity, respectively. High risk group was associated with higher distant metastasis rate (p = 0.02) and death from prostate cancer (p = 0.0012).
  
  
  CONCLUSIONS
  This study represents one of the longest experiences with intensity modulated radiation therapy for prostate cancer. With a median followup of 91 months, intensity modulated radiation therapy resulted in durable biochemical control rates with low chronic toxicity.
authors: Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona 85045, USA. vora.sujay@mayo.edu
authors: Sujay A
authors: SA
authors: Vora
authors: William W
authors: WW
authors: Wong
authors: Steven E
authors: SE
authors: Schild
authors: Gary A
authors: GA
authors: Ezzell
authors: Paul E
authors: PE
authors: Andrews
authors: Robert G
authors: RG
authors: Ferrigni
authors: Scott K
authors: SK
authors: Swanson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: 3-D; 3-dimensional; ADT; ASTRO; American Society for Therapeutic Radiology and Oncology; CT; CTCAE; CTV; Common Terminology Criteria for Adverse Events; GI; GU; IMRT; NCCN; National Comprehensive Cancer Network; PSA; RT; androgen deprivation therapy; clinical target volume; computerized tomography; gastrointestinal; genitourinary; intensity modulated radiation therapy; prostate specific antigen; prostatic neoplasms; radiotherapy; radiotherapy, intensity-modulated; toxicity