Abstract: Purpose: To report the toxicity and long-term outcomes of dose-escalated intensity-modulated radiation therapy (IMRT) for patients with localised prostate cancer. Methods and Materials: From 2001 to 2005, a total of 125 patients with histologically confirmed T1-3N0M0 prostate cancer were treated with IMRT to 74Gy at the Austin Health Radiation Oncology Centre. The median follow-up was 5.5 years (range 0.5–8.9 years). Biochemical prostate specific antigen (bPSA) failure was defined according to the Phoenix consensus definition (absolute nadir + 2ng/mL). Toxicity was scored according to the RTOG/EORTC criteria. Kaplan-Meier analysis was used to calculate toxicity rates, as well as the risks of bPSA failure, distant metastases, disease-specific and overall survival, at 5 and 8-years post treatment. Results: All patients completed radiotherapy without any treatment breaks. The 8-year risks of ≥ Grade 2 genitourinary (GU) and gastrointestinal (GI) toxicity were 6.4% and 5.8% respectively, and the 8-year risks of ≥ Grade 3 GU and GI toxicity were both < 0.05%. The 5 and 8-year freedom from bPSA failure were 76% and 58% respectively. Disease-specific survival at 5 and 8 years were 95% and 91%, respectively, and overall survival at 5 and 8 years were 90% and 71%, respectively. Conclusions: These results confirm existing international data regarding the safety and efficacy of dose-escalated intensity-modulated radiation therapy for localised prostate cancer within an Australian setting.
Keywords: dose escalation; IMRT; late effects; prostate cancer; toxicity; radiation
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Sia, J.; Joon, D.L.; Viotto, A.; Mantle, C.; Quong, G.; Rolfo, A.; Wada, M.; Anderson, N.; Rolfo, M.; Khoo, V. Toxicity and Long-Term Outcomes of Dose-Escalated Intensity Modulated Radiation Therapy to 74Gy for Localised Prostate Cancer in a Single Australian Centre. Cancers 2011, 3, 3419-3431.
Sia J, Joon DL, Viotto A, Mantle C, Quong G, Rolfo A, Wada M, Anderson N, Rolfo M, Khoo V. Toxicity and Long-Term Outcomes of Dose-Escalated Intensity Modulated Radiation Therapy to 74Gy for Localised Prostate Cancer in a Single Australian Centre. Cancers. 2011; 3(3):3419-3431.
Sia, Joseph; Joon, Daryl Lim; Viotto, Angela; Mantle, Carmel; Quong, George; Rolfo, Aldo; Wada, Morikatsu; Anderson, Nigel; Rolfo, Maureen; Khoo, Vincent. 2011. "Toxicity and Long-Term Outcomes of Dose-Escalated Intensity Modulated Radiation Therapy to 74Gy for Localised Prostate Cancer in a Single Australian Centre." Cancers 3, no. 3: 3419-3431.