Cargando…
Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy
BACKGROUND: To report about initial clinical experience in radiation treatment of carcinoma of prostate with volumetric modulated arcs with the RapidArc (RA) technology. METHODS: Forty-five patients with a median age of 72 ± 3, affected by prostate carcinoma (T1c: 22 patients, T2a-b: 17 patients, T3...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2010
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902493/ https://www.ncbi.nlm.nih.gov/pubmed/20550722 http://dx.doi.org/10.1186/1748-717X-5-54 |
_version_ | 1782183772086599680 |
---|---|
author | Pesce, Gianfranco A Clivio, Alessandro Cozzi, Luca Nicolini, Giorgia Richetti, Antonella Salati, Emanuela Valli, Mariacarla Vanetti, Eugenio Fogliata, Antonella |
author_facet | Pesce, Gianfranco A Clivio, Alessandro Cozzi, Luca Nicolini, Giorgia Richetti, Antonella Salati, Emanuela Valli, Mariacarla Vanetti, Eugenio Fogliata, Antonella |
author_sort | Pesce, Gianfranco A |
collection | PubMed |
description | BACKGROUND: To report about initial clinical experience in radiation treatment of carcinoma of prostate with volumetric modulated arcs with the RapidArc (RA) technology. METHODS: Forty-five patients with a median age of 72 ± 3, affected by prostate carcinoma (T1c: 22 patients, T2a-b: 17 patients, T3a-b: 6 patients. N0: 43 patients, N1-Nx: 2 patients, all M0), with initial PSA of 10.0 ± 3.0 ng/mL, were treated with RapidArc in a feasibility study. All patients were treated with single arc using 6MV photons. Dose prescription ranged between 76 (7 patients) and 78 Gy (38 patients) in 2Gy/fraction. Plan quality was assessed by means of Dose Volume Histogram (DVH) analysis. Technical parameters of arcs and pre-treatment quality assurance results (Gamma Agreement Index, GAI) are reported to describe delivery features. Early toxicity was scored (according to the Common Terminology Criteria of Adverse Effects scale, CTCAE, scale) at the end of treatment together with biochemical outcome (PSA). RESULTS: From DVH data, target coverage was fulfilling planning objectives: V(95% )was in average higher than 98% and V(107%)~0.0% (D(2%)~104.0% in average). Homogeneity D(5%)-D(95% )ranged between 6.2 ± 1.0% to 6.7 ± 1.3%. For rectum, all planning objectives were largely met (e.g. V(70Gy )= 10.7 ± 5.5% against an objective of < 25%) similarly for bladder (e.g. D(2% )= 79.4 ± 1.2Gy against an objective of 80.0Gy). Maximum dose to femurs was D(2% )= 36.7 ± 5.4Gy against an objective of 47Gy. Monitor Units resulted: MU/Gy = 239 ± 37. Average beam on time was 1.24 ± 0.0 minutes. Pre-treatment GAI resulted in 98.1 ± 1.1%. Clinical data were recorded as PSA at 6 weeks after RT, with median values of 0.4 ± 0.4 ng/mL. Concerning acute toxicity, no patient showed grade 2-3 rectal toxicity; 5/42 (12%) patients experienced grade 2 dysuria; 18/41 (44%) patients preserved complete or partial erectile function. CONCLUSION: RapidArc proved to be a safe, qualitative and advantageous treatment modality for prostate cancer. |
format | Text |
id | pubmed-2902493 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-29024932010-07-13 Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy Pesce, Gianfranco A Clivio, Alessandro Cozzi, Luca Nicolini, Giorgia Richetti, Antonella Salati, Emanuela Valli, Mariacarla Vanetti, Eugenio Fogliata, Antonella Radiat Oncol Research BACKGROUND: To report about initial clinical experience in radiation treatment of carcinoma of prostate with volumetric modulated arcs with the RapidArc (RA) technology. METHODS: Forty-five patients with a median age of 72 ± 3, affected by prostate carcinoma (T1c: 22 patients, T2a-b: 17 patients, T3a-b: 6 patients. N0: 43 patients, N1-Nx: 2 patients, all M0), with initial PSA of 10.0 ± 3.0 ng/mL, were treated with RapidArc in a feasibility study. All patients were treated with single arc using 6MV photons. Dose prescription ranged between 76 (7 patients) and 78 Gy (38 patients) in 2Gy/fraction. Plan quality was assessed by means of Dose Volume Histogram (DVH) analysis. Technical parameters of arcs and pre-treatment quality assurance results (Gamma Agreement Index, GAI) are reported to describe delivery features. Early toxicity was scored (according to the Common Terminology Criteria of Adverse Effects scale, CTCAE, scale) at the end of treatment together with biochemical outcome (PSA). RESULTS: From DVH data, target coverage was fulfilling planning objectives: V(95% )was in average higher than 98% and V(107%)~0.0% (D(2%)~104.0% in average). Homogeneity D(5%)-D(95% )ranged between 6.2 ± 1.0% to 6.7 ± 1.3%. For rectum, all planning objectives were largely met (e.g. V(70Gy )= 10.7 ± 5.5% against an objective of < 25%) similarly for bladder (e.g. D(2% )= 79.4 ± 1.2Gy against an objective of 80.0Gy). Maximum dose to femurs was D(2% )= 36.7 ± 5.4Gy against an objective of 47Gy. Monitor Units resulted: MU/Gy = 239 ± 37. Average beam on time was 1.24 ± 0.0 minutes. Pre-treatment GAI resulted in 98.1 ± 1.1%. Clinical data were recorded as PSA at 6 weeks after RT, with median values of 0.4 ± 0.4 ng/mL. Concerning acute toxicity, no patient showed grade 2-3 rectal toxicity; 5/42 (12%) patients experienced grade 2 dysuria; 18/41 (44%) patients preserved complete or partial erectile function. CONCLUSION: RapidArc proved to be a safe, qualitative and advantageous treatment modality for prostate cancer. BioMed Central 2010-06-16 /pmc/articles/PMC2902493/ /pubmed/20550722 http://dx.doi.org/10.1186/1748-717X-5-54 Text en Copyright ©2010 Pesce et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Pesce, Gianfranco A Clivio, Alessandro Cozzi, Luca Nicolini, Giorgia Richetti, Antonella Salati, Emanuela Valli, Mariacarla Vanetti, Eugenio Fogliata, Antonella Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy |
title | Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy |
title_full | Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy |
title_fullStr | Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy |
title_full_unstemmed | Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy |
title_short | Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy |
title_sort | early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902493/ https://www.ncbi.nlm.nih.gov/pubmed/20550722 http://dx.doi.org/10.1186/1748-717X-5-54 |
work_keys_str_mv | AT pescegianfrancoa earlyclinicalexperienceofradiotherapyofprostatecancerwithvolumetricmodulatedarctherapy AT clivioalessandro earlyclinicalexperienceofradiotherapyofprostatecancerwithvolumetricmodulatedarctherapy AT cozziluca earlyclinicalexperienceofradiotherapyofprostatecancerwithvolumetricmodulatedarctherapy AT nicolinigiorgia earlyclinicalexperienceofradiotherapyofprostatecancerwithvolumetricmodulatedarctherapy AT richettiantonella earlyclinicalexperienceofradiotherapyofprostatecancerwithvolumetricmodulatedarctherapy AT salatiemanuela earlyclinicalexperienceofradiotherapyofprostatecancerwithvolumetricmodulatedarctherapy AT vallimariacarla earlyclinicalexperienceofradiotherapyofprostatecancerwithvolumetricmodulatedarctherapy AT vanettieugenio earlyclinicalexperienceofradiotherapyofprostatecancerwithvolumetricmodulatedarctherapy AT fogliataantonella earlyclinicalexperienceofradiotherapyofprostatecancerwithvolumetricmodulatedarctherapy |