title: Outcomes of high-dose intensity-modulated radiotherapy alone with 1 cm planning target volume posterior margin for localized prostate cancer.
abstract: BACKGROUND
  Clinically localized prostate cancer may be treated by different approaches of radiation therapy. The aim of this study was to report the results of disease control and toxicity in patients with clinically localized prostate cancer treated with high dose IMRT alone with 1 cm PTV posterior margin.
  
  
  METHODS
  From September 2001 to April 2008, 140 patients with localized prostate cancer were treated with definitive IMRT (dose ≥ 74 Gy) without hormone therapy. Outcomes were measured from the conclusion of radiotherapy. Biochemical failure was defined as PSA nadir + 2.0 ng/dL. Toxicities were assessed using the NCI-CTCAE-version 3.0. Median follow-up was 58 months.
  
  
  RESULTS
  Biochemical failure occurred in 13.6% of patients. Actuarial 5-year biochemical control rates were 91.7%, 82.5% and 85.9% for low-, intermediate-, and high-risk patients, respectively. Stage T2 patients presented a risk of biochemical failure almost three times higher than stage T1 (RR = 2.91; 95% CI: 1.04; 8.17). Distant metastases occurred in 3 (2%) patients. Five-year metastasis-free and overall survivals were 96% and 97.5%, respectively. Late grade 3 genitourinary and gastrointestinal toxicity rates were, respectively, 1.6% and 3%.
  
  
  CONCLUSIONS
  High-dose IMRT alone with 1 cm posterior PTV margin was effective and safe for patients with localized prostate cancer.
authors: Department of Radiation Oncology, Hospital Sírio Libanês, Rua Dona Adma Jafet, 91, Sao Paulo, Brazil. rafael.gadia@hsl.org.br.
authors: Rafael
authors: R
authors: Gadia
authors: Élton T
authors: ÉT
authors: Leite
authors: Flavia G
authors: FG
authors: Gabrielli
authors: Gustavo N
authors: GN
authors: Marta
authors: Fernando F
authors: FF
authors: Arruda
authors: Carlos V
authors: CV
authors: Abreu
authors: Samir A
authors: SA
authors: Hanna
authors: Cecilia K
authors: CK
authors: Haddad
authors: João F
authors: JF
authors: Silva
authors: Heloisa A
authors: HA
authors: Carvalho
authors: Bernardo
authors: B
authors: Garicochea
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010315:Particle Accelerators; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011878:Radiotherapy / Q000379:methods; D061089:Radiotherapy, Image-Guided / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012189:Retrospective Studies; D012306:Risk; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome