- 作者：Michael A. Myers ; Michael P. Hagan ; Dorin Todor ; Lynn Gilbert ; Nitai Mukhopadhyay ; Jessica Randolf ; Jeffrey Heimiller ; Mitchell S. Anscher ; manscher@mcvh-vcu.edu
- 关键词：Prostate cancer ; Single fraction HDR boost ; Hypofractionated ; IMRT
- 刊名：Brachytherapy
- 出版年：2012
- 期刊代码：278_15384721
- 类别：med
- 出版时间：July-August, 2012
- 卷：11
- 期：4
- 页码：292-298
- 文件大小：286 K
Purpose
A Phase I/II protocol was conducted to examine the toxicity and efficacy of the combination of intensity-modulated radiation therapy (IMRT) with a single-fraction high-dose-rate (HDR) brachytherapy implant.Methods and Materials
From 2001 through 2006, 26 consecutive patients were treated on the trial. The primary objective was to demonstrate a high rate of completion without experiencing a treatment-limiting toxicity. Eligibility was limited to patients with T stage 鈮?b, prostate-specific antigen (PSA) 鈮?0, and Gleason score 鈮?. Treatment began with a single HDR fraction of 6 Gy to the entire prostate and 9 Gy to the peripheral zone, followed by IMRT optimized to deliver in 28 fractions with a normalized total dose of 70 Gy. Patients received 50.4 Gy to the pelvic lymph node. The prostate dose (IMRT and HDR) resulted in an average biologic equivalent dose >128 Gy (伪/尾 = 3). Patients whose pretreatment PSA was 鈮?0 ng/mL, Gleason score 7, or stage 鈮2b received short-term androgen ablation.
Results
Median followup was 53 months (9-68 months). There were no biochemical failures by either the American Society of Therapeutic Radiology and Oncology or the Phoenix definitions. The median nadir PSA was 0.32 ng/mL. All the 26 patients completed the treatment as prescribed. The rate of Grade 3 late genitourinary toxicity was 3.8%consisting of a urethral stricture. There was no other Grade 3 or 4 genitourinary or gastrointestinal toxicities.
Conclusions
Single-fraction HDR-boosted IMRT is a safe effective method of dose escalation for localized prostate cancer.