title: Whole pelvic intensity-modulated radiotherapy for high-risk prostate cancer: a preliminary report.
abstract: OBJECTIVE
  To assess the clinical efficacy and toxicity of whole pelvic intensity-modulated radiotherapy (WP-IMRT) for high-risk prostate cancer.
  
  
  METHODS
  Patients with high-risk prostate cancer treated between 2008 and 2013 were reviewed. The study included patients who had undergone WP-IMRT with image guidance using electronic portal imaging devices and/or cone-beam computed tomography. The endorectal balloon was used in 93% of patients. Patients received either 46 Gy to the whole pelvis plus a boost of up to 76 Gy to the prostate in 2 Gy daily fractions, or 44 Gy to the whole pelvis plus a boost of up to 72.6 Gy to the prostate in 2.2 Gy fractions.
  
  
  RESULTS
  The study cohort included 70 patients, of whom 55 (78%) had a Gleason score of 8 to 10 and 50 (71%) had a prostate-specific antigen level > 20 ng/mL. The androgen deprivation therapy was combined in 62 patients. The biochemical failure-free survival rate was 86.7% at 2 years. Acute any grade gastrointestinal (GI) and genitourinary (GU) toxicity rates were 47% and 73%, respectively. The actuarial rate of late grade 2 or worse toxicity at 2 years was 12.9% for GI, and 5.7% for GU with no late grade 4 toxicity.
  
  
  CONCLUSIONS
  WP-IMRT was well tolerated with no severe acute or late toxicities, resulting in at least similar biochemical control to that of the historic control group with a small field. The long-term efficacy and toxicity will be assessed in the future, and a prospective randomized trial is needed to verify these findings.
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Ji Hyeon
authors: JH
authors: Joo
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Yeon Joo
authors: YJ
authors: Kim
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Young Seok
authors: YS
authors: Kim
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Eun Kyung
authors: EK
authors: Choi
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Jong Hoon
authors: JH
authors: Kim
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Sang-Wook
authors: SW
authors: Lee
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Si Yeol
authors: SY
authors: Song
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Sang Min
authors: SM
authors: Yoon
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Su Ssan
authors: SS
authors: Kim
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Jin-Hong
authors: JH
authors: Park
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Yuri
authors: Y
authors: Jeong
authors: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Hanjong
authors: H
authors: Ahn
authors: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Choung-Soo
authors: CS
authors: Kim
authors: Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Jae-Lyun
authors: JL
authors: Lee
authors: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Seung Do
authors: SD
authors: Ahn
keywords: Complications; Intensity-modulated radiotherapy; Prostate neoplasms