title: Volumetric Modulated Arc Therapy of the Pelvic Lymph Nodes to the Aortic Bifurcation in Higher Risk Prostate Cancer: Early Toxicity Outcomes.
abstract: BACKGROUND
  Treatment of pelvic lymph nodes (PLNs) in higher risk prostate carcinoma is controversial. The primary focus of the study was to evaluate the early toxicity profile for this cohort of patients treated with Volumetric Modulated Arc Therapy (VMAT).
  
  
  METHODS
  Patient, tumour, and treatment characteristics of those who received VMAT from May 2010 to December 2012 were analysed. A simplified contouring process of the PLNs to the aortic bifurcation was developed based on consensus guidelines. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities were documented according to the Radiation Therapy Oncology Group (RTOG) Version 2 Guidelines. Successive Prostate Specific Antigen (PSA) values after treatment were measured on average 3 months apart.
  
  
  RESULTS
  113 patients were treated between May 2010 to December 2012 with a median follow-up of 14 months. No patients experienced acute grade 3 or 4 GU and GI toxicity. Only 1 patient experienced a late grade 3 GU complication. No late grade 4 GU or GI events have yet occurred.
  
  
  CONCLUSIONS
  This study reviews the first Australian experience of VMAT in the treatment of pelvic lymph nodes in prostate cancer, specifically to the level of the aortic bifurcation. It demonstrates a favorable acute toxicity profile whilst treating large PLN volumes with optimal dose coverage.
authors.affiliation: Prince of Wales Hospital, High Street, Randwick, NSW 2031, Australia ; University of New South Wales, High Street, Kensington, NSW 2052, Australia.
authors.forename: Gina
authors.initials: G
authors.lastname: Hesselberg
authors.affiliation: Genesis Cancer Care, Mater Sydney Radiation Oncology, 25 Rocklands Road, Crows Nest, NSW 2065, Australia ; University of Texas MD Anderson Cancer Center, Surgical Oncology, 1400 Pressler Street, FCT 17.6000, Houston, TX, USA ; St Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW 2010, Australia.
authors.forename: Gerald
authors.initials: G
authors.lastname: Fogarty
authors.affiliation: University of Texas MD Anderson Cancer Center, Surgical Oncology, 1400 Pressler Street, FCT 17.6000, Houston, TX, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Haydu
authors.affiliation: Genesis Cancer Care, Mater Sydney Radiation Oncology, 25 Rocklands Road, Crows Nest, NSW 2065, Australia.
authors.forename: Nicole
authors.initials: N
authors.lastname: Dougheney
authors.affiliation: St Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW 2010, Australia.
authors.forename: Phillip
authors.initials: P
authors.lastname: Stricker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000532:radiotherapy*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects* / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen