title: Significance of image guidance to clinical outcomes for localized prostate cancer.
abstract: OBJECTIVE
  To compare toxicity profiles and biochemical tumor control outcomes between patients treated with image-guided intensity-modulated radiotherapy (IG-IMRT) and non-IGRT intensity-modulated radiotherapy (IMRT) for clinically localized prostate cancer.
  
  
  METHODS
  Between 2009 and 2012, 65 patients with localized prostate cancer were treated with IG-IMRT. This group of patients was retrospectively compared with a similar cohort of 62 patients who were treated between 2004 and 2009 with IMRT to the same dose without image guidance.
  
  
  RESULTS
  The median follow-up time was 4.8 years. The rectal volume receiving ≥40 and ≥70 Gy was significantly lower in the IG-IMRT group. Grade 2 and higher acute and late GI and GU toxicity rates were lower in IG-IMRT group, but there was no statistical difference. No significant improvement in biochemical control at 5 years was observed in two groups. In a Cox regression analysis identifying predictors for PSA relapse-free survival, only preradiotherapy PSA was significantly associated with biochemical control; IG-IMRT was not a statistically significant indicator.
  
  
  CONCLUSIONS
  The use of image guidance in the radiation of prostate cancer at our institute did not show significant reduction in the rates of GI and GU toxicity and did not improve the biochemical control compared with IMRT.
authors.affiliation: Department of Radiotherapy, Beijing Hospital, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing 100730, China.
authors.forename: Qiuzi
authors.initials: Q
authors.lastname: Zhong
authors.affiliation: Department of Radiotherapy, Beijing Hospital, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing 100730, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Gao
authors.affiliation: Department of Radiotherapy, Beijing Hospital, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing 100730, China.
authors.forename: Gaofeng
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Radiotherapy, Beijing Hospital, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing 100730, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Xiu
authors.affiliation: Department of Radiotherapy, Beijing Hospital, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing 100730, China.
authors.forename: Qinhong
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of Radiotherapy, Beijing Hospital, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing 100730, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Radiotherapy, Beijing Hospital, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing 100730, China.
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Xu
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D009928:Organ Specificity; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D011874:Radiometry; D061089:Radiotherapy, Image-Guided / Q000009:adverse effects; D050397:Radiotherapy, Intensity-Modulated; D012307:Risk Factors; D013997:Time Factors
chemical_list: D017430:Prostate-Specific Antigen
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