Radiat Oncol J.  2014 Sep;32(3):187-197. 10.3857/roj.2014.32.3.187.

Treatment outcome of localized prostate cancer by 70 Gy hypofractionated intensity-modulated radiotherapy with a customized rectal balloon

• Kim H
• Kim JW
• Hong SJ
• Rha KH
• Lee CG
• Yang SC
• Choi YD
• Suh CO
• Cho J

• KMID: 2316734
• DOI: http://doi.org/10.3857/roj.2014.32.3.187

Abstract

PURPOSE
We aimed to analyze the treatment outcome and long-term toxicity of 70 Gy hypofractionated intensity-modulated radiotherapy (IMRT) for localized prostate cancer using a customized rectal balloon.
MATERIALS AND METHODS
We reviewed medical records of 86 prostate cancer patients who received curative radiotherapy between January 2004 and December 2011 at our institution. Patients were designated as low (12.8%), intermediate (20.9%), or high risk (66.3%). Thirty patients received a total dose of 70 Gy in 28 fractions over 5 weeks via IMRT (the Hypo-IMRT group); 56 received 70.2 Gy in 39 fractions over 7 weeks via 3-dimensional conformal radiotherapy (the CF-3DRT group, which served as a reference for comparison). A customized rectal balloon was placed in Hypo-IMRT group throughout the entire radiotherapy course. Androgen deprivation therapy was administered to 47 patients (Hypo-IMRT group, 17; CF-3DRT group, 30). Late genitourinary (GU) and gastrointestinal (GI) toxicity were evaluated according to the Radiation Therapy Oncology Group criteria.
RESULTS
The median follow-up period was 74.4 months (range, 18.8 to 125.9 months). The 5-year actuarial biochemical relapse-free survival rates for low-, intermediate-, and high-risk patients were 100%, 100%, and 88.5%, respectively, for the Hypo-IMRT group and 80%, 77.8%, and 63.6%, respectively, for the CF-3DRT group (p < 0.046). No patient presented with acute or late GU toxicity > or =grade 3. Late grade 3 GI toxicity occurred in 2 patients (3.6%) in the CF-3DRT group and 1 patient (3.3%) in the Hypo-IMRT group.
CONCLUSION
Hypo-IMRT with a customized rectal balloon resulted in excellent biochemical control rates with minimal toxicity in localized prostate cancer patients.

Keyword

Prostatic neoplasm; Hypofractionation; Rectal Balloon; Radiotherapy; Intensity modulation

MeSH Terms

Follow-Up Studies
Humans
Medical Records
Prostatic Neoplasms*
Radiotherapy
Radiotherapy, Conformal
Radiotherapy, Intensity-Modulated*
Survival Rate
Treatment Outcome*