Simultaneous Integrated Boost-Intensity Modulated Radiotherapy (SIB-IMRT) for the Whole Pelvis did not Lead to Significantly Higher Toxicity Rates than ProstateOnly IMRT in Prostate Cancer Patients

Zaghloul MS, Tolba M, Elkady MS, May Ezz El Din, Ammar H, Amin A, Mousa AG and Bakry MS

Department of Radiation Oncology, Children’s Cancer Hospital, Cairo University, Egypt
Ain Shams Faculty of Medicine, Egypt

^*Correspondance to: Mohamed S. Zaghloul 

 PDF  Full Text Case Report | Open Access

Abstract:

Purpose: To explore the controversy of including pelvic nodes in radical radiotherapy for prostate cancer with the adopted of precise advanced techniques of Intensity Modulated Radiotherapy (IMRT) and verified through image-guidance. Patients and
Methods: Twenty prostate cancer patients were treated using SIB-IMRT whole pelvis irradiation for high-risk (10) patients. They received a median dose of 77.7 Gy to prostate and 54-58 Gy to nodes over a median of 37 fractions. Intermediate-risk (10) patients received a similar prostate dose over the same overall treatment time.Results: The dose coverage to the prostate was identical in both groups with a mean PITV of 1.2 ± 0.1 and a confirmation index of 0.73 ± 0.07. Although the volume of the bladder and rectum that received 50,60,65,70 Gy (V50,V60,V65,V70) in the whole pelvis group were larger than the corresponding volume in prostate group yet, none of the difference was statistically significant. The mean dose received by femoral head was higher in the whole pelvis than in prostate group. However their D5 (volume received ≥5 Gy) were almost identical. No significant acute toxicity difference was experienced by the patients in the 2 groups. The 4-year cumulative bladder late toxicity-free rate was 100% in prostate group while it was 67 ± 27% in the whole pelvis group (p=0.116). On the other hand, no late rectal toxicities were reported in the 2 groups. The biochemical failure-free and overall survival rates were 85.7 ± 13.2% and 100% in prostate group and 75.0 ± 21.7% & 80.0 ± 12.6% in the whole pelvis group with no statistical significance.Conclusion: Although the acute and late radiation toxicities were slightly higher with whole pelvis than prostate irradiation yet, it was not of statistical significance.

Keywords:

Prostate cancer; High-risk; Intermediate-risk; Simultaneous integrated boostintensity modulated radiotherapy; SIB-IMRT; Acute toxicity; Late toxicity

Cite the Article:

Zaghloul MS, Tolba M, Elkady MS, May Ezz El Din, Ammar H, Amin A, et al. Simultaneous Integrated Boost-Intensity Modulated Radiotherapy (SIB-IMRT) for the Whole Pelvis did not Lead to Significantly Higher Toxicity Rates than Prostate-Only IMRT in Prostate Cancer Patients. Clin Oncol. 2016; 1: 1109.