Produção Nacional
Revisado por pares
Intensity-modulated Radiotherapy With Simultaneous Integrated Boost to Dominant Intraprostatic Lesion
2011; Lippincott Williams & Wilkins; Volume: 35; Issue: 2 Linguagem: Inglês
10.1097/coc.0b013e318209cd8f
ISSN1537-453X
AutoresEdy Ippolito, Giovanna Mantini, A.G. Morganti, Ercole Mazzeo, Gilbert D. A. Padula, Cinzia Digesú, Savino Cilla, V. Frascino, S. Luzi, Mariangela Massaccesi, Gabriella Macchia, Francesco Deodato, Gian Carlo Mattiucci, A. Piermattei, Numa Cellini,
Tópico(s)Advanced Radiotherapy Techniques
ResumoObjectives To evaluate the feasibility of intensity-modulated radiotherapy with simultaneous integrated boost to the dominant intraprostatic lesion for definitive treatment of prostate cancer. Materials and Methods Patients were deemed eligible for the study if they had histologically proven stage cT2-T3 N0M0 prostate adenocarcinoma. In addition <20% risk of lymph nodal involvement according to Roach formula, was required for enrollment. Patients were treated with intensity-modulated radiotherapy with simultaneous integrated boost technique to the dominant intraprostatic lesion defined by magnetic resonance imaging. The prescribed dose to the prostate and seminal vesicles was 72 Gy (1.8 Gy per fraction). The dose delivered to the intraprostatic lesion received was 80 Gy (2 Gy per fraction). Acute gastrointestinal (GI) and genitourinary (GU) toxicity was evaluated weekly during treatment, and at 1 and 3 months thereafter. Late GI and GU toxicity was evaluated by Kaplan Meier method. Results Forty patients were deemed evaluable. Acute and late GI and GU toxicity were evaluated in all patients. Two patients (5%) developed acute grade 3 GI toxicity and 1 patient (2.5%) developed acute grade 3 GU toxicity. No grade 4 acute GI or GU toxicity occurred. With a median follow-up of 19 months (interquartile range, 15 to 26 mo), the 2-year actuarial cumulative incidence of grade ≥2 rectal toxicity was 9.5%. The 2-year actuarial cumulative incidence of grade ≥2 urinary toxicity was 13.3%. Conclusions Treatment related acute toxicity was low in our cohort. Prolonged observation with a larger series of patients is necessary to evaluate late toxicity and local control.
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