論文

査読有り
2014年5月

Early results of urethral dose reduction and small safety margin in intensity-modulated radiation therapy (IMRT) for localized prostate cancer using a real-time tumor-tracking radiotherapy (RTRT) system

RADIATION ONCOLOGY
  • Shinichi Shimizu
  • ,
  • Kentaro Nishioka
  • ,
  • Ryusuke Suzuki
  • ,
  • Nobuo Shinohara
  • ,
  • Satoru Maruyama
  • ,
  • Takashige Abe
  • ,
  • Rumiko Kinoshita
  • ,
  • Norio Katoh
  • ,
  • Rikiya Onimaru
  • ,
  • Hiroki Shirato

9
開始ページ
118
終了ページ
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/1748-717X-9-118
出版者・発行元
BIOMED CENTRAL LTD

Background: We prospectively assessed the utility of intensity-modulated radiation therapy (IMRT) with urethral dose reduction and a small margin between the clinical target volume (CTV) and the planning target volume (PTV) for patients with localized prostate cancer.
Methods: The study population was 110 patients in low- (14.5%), intermediate- (41.8%), and high-risk (43.6%) categories. Three gold fiducial markers were inserted into the prostate. A soft guide-wire was used to identify the urethra when computed tomography (CT) scan for treatment planning was performed. A dose constraint of V70 < 10% was applied to the urethral region. Margins between the CTV-PTV were set at 3 mm in all directions. Patients were treated with 70 Gy IMRT in 30 fractions (D95 of PTV) over 7.5 weeks. The patient couch was adjusted to keep the gold markers within 2.0 mm from their planned positions with the use of frequent on-line verification.
Results: The median follow-up period was 31.3 (3.2 to 82.1) months. The biochemical relapse-free survival (bRFS) rates at 3 years were 100%, 93.8% and 89.5% for the low-, intermediate-, and high-risk patients, respectively. The incidences of acute adverse events (AEs) were 45.5% and 0.9% for grades 1 and 2, respectively. The late AEs were grade 1 cystitis in 10.0% of the patients, rectal bleeding in 7.3%, and urinary urgency in 6.4%. Only three patients (2.7%) developed grade 2 late AEs.
Conclusions: On-line image guidance with precise correction of the table position during radiotherapy achieved one of the lowest AEs rates with a bRFS equal to the highest in the literature.

Web of Science ® 被引用回数 : 12

リンク情報
DOI
https://doi.org/10.1186/1748-717X-9-118
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/24884868
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000336936000002&DestApp=WOS_CPL

エクスポート
BibTeX RIS