Reduction in acute morbidity using hypofractionated intensity-modulated radiation therapy assisted with a fluoroscopic real-time tumor-tracking system for prostate cancer: preliminary results of a phase I/II study.
Purpose: The positioning of the prostate is improved with the use of the fluoroscopic real-time tumor-tracking radiation therapy system for prostate cancer. The acute radiation reaction and preliminary tumor response of prostate cancer to hypofractionated intensity-modulated radiation therapy assist...
| Publicado en: | Cancer Journal Vol. 9; no. 4; pp. 268 - 277 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | clinical trial diagnostic images research tables/charts Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Jul/Aug2003
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106751503&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106751503 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15289117 4U5 jtl: Cancer Journal issn: 15289117 maglogo: N pubinfo: dt: Jul/Aug2003 vid: 9 iid: 4 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 106751503 106751503 NLM12967137 2004111820 10.1097/00130404-200307000-00009 NLM12967137 106751503 ppf: 268 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Reduction in acute morbidity using hypofractionated intensity-modulated radiation therapy assisted with a fluoroscopic real-time tumor-tracking system for prostate cancer: preliminary results of a phase I/II study. aug: au: Kitamura K Shirato H Shinohara N Harabayashi T Onimaru R Fujita K Shimizu S Nonomura K Koyanagi T Miyasaka K Kitamura, Kei Shirato, Hiroki Shinohara, Nobuo Harabayashi, Toru Onimaru, Rikiya Fujita, Katsuhisa Shimizu, Shinichi Nonomura, Katsuya Koyanagi, Tomohiko Miyasaka, Kazuo affil: Department of Radiology, Hokkaido University School of Medicine, Sapporo, Japan sug: subj: Prostatic Neoplasms Radiotherapy Radiotherapy Methods Dose-Response Relationship, Radiation Radiotherapy Adverse Effects Radiation Injuries Etiology Therapy, Computer Assisted Treatment Outcomes Radiation Dosage Fluoroscopy Clinical Trials Chi Square Test Human ab: Purpose: The positioning of the prostate is improved with the use of the fluoroscopic real-time tumor-tracking radiation therapy system for prostate cancer. The acute radiation reaction and preliminary tumor response of prostate cancer to hypofractionated intensity-modulated radiation therapy assisted with real-time tumor-tracking radiation therapy were investigated in this study.Methods: Patients were classified into prognostic risk groups on the basis of the presence of the pretreatment prostate-specific antigen, clinical stage, and histologic differentiation. Neoadjuvant hormonal therapy was administered to patients in the high-risk group for 6 months before radiation therapy commenced. The intensity-modulated radiation therapy employed a segmental multileaf collimator, which generated a field made up of two or more shaped subfields using forward planning. Real-time tumor-tracking radiation therapy was used for the precise positioning of the prostate to minimize geometric uncertainties, while the dose was escalated in increments of 5 Gy from 65 Gy using a daily dose of 2.5 Gy (65 Gy/2.5 Gy), following the dose-escalation rules. Acute and late gastrointestinal and genitourinary morbidities due to radiation therapy were scored according to the toxicity criteria of Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer.Results: Thirty-one patients were enrolled in this study between 1998 and 2001. Eighteen patients were classified as being members of the high-risk group. Total dose was escalated, with 65 Gy/2.5 Gy being administered to 12 patients and 70 Gy/2.5 Gy to 19 patients. The median follow-up period was 37 months (range, 30-43 months), and 19 months (range, 10-27 months), for the 65-Gy and 70-Gy arms, respectively. Patients experienced no acute toxicity and grade 1 late gastrointestinal toxicity (8.3%) in the 65-Gy/2.5-Gy arm. Patients in the 70-Gy/2.5-Gy arm experienced grade 1 acute gastrointestinal toxicity (5.3%) and grade 1 and 2 acute genitourinarytoxicities (15.8%). No patients experienced dose-limiting toxicity (defined as a grade 3 or higher acute toxicity) or a grade 2 or higher late complication in this study period. One and two prostate-specific antigen relapses were observed in the 65-Gy and 70-Gy arms, respectively.Conclusion: Up to 70 Gy/2.5 Gy, equivalent to 80 Gy with a daily dose of 2.0 Gy, assuming alpha/beta ratio of 1.5, intensity-modulated radiation therapy assisted with real-time tumor-tracking radiation therapy was administered safely with a reasonable biochemical control rate. A further dose-escalation study using this system is justifiable. pubtype: Academic Journal doctype: clinical trial diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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