THE WAY FOR OPTIMIZATION OF DISTANT RADIATION THERAPY IN PROSTATE CANCER

Cover Page


Cite item

Full Text

Abstract

Background: The rationale for distant gamma therapy (DGT) in prostate cancer patients is the data of its effectiveness in combination with modern planner devices, as well as lower costs, compared to the use of a linear accelerator.
Aim: To access the impact of DGT based on a 3D planning software “Amphora” on the 5-year survival rate depending on the main predictors of treatment efficacy in prostate cancer patients.
Materials and methods: The study included 34 prostate cancer patients who received low-dose DGT (total focal dose of 62 to 70 Gr). Androgen deprivation was used in 73.5% of patients for 6 to 12 months.
Results: The patients with a baseline pros tate-specific antigen level < 20 ng/ml had the highest 5-year survival rate of 86%. There was no significant difference in a 5-year survival that depending on a total focal dose (< 64 Gr; ≥ 64 Gr) of DGT if used in combination with androgen deprivation. Conclusion: This data represents only the first step in establishment of the criteria to choose the type of DGT in prostate cancer patients. The optimization of a treatment strategy based on a thorough analysis of data, including that on comorbidities and their severity, would make the use of DGT more rational that will reduce costs of treatment.

About the authors

A. S. Balkanov

Moscow Regional Research and Clinical Institute

Author for correspondence.
Email: andreybalkanov@yandex.ru
Balkanov Andrey Sergeevich – MD, PhD, Head of Department of Radiology Russian Federation

References

  1. Surapaneni A, Schwartz D, Nwokedi E, Rineer J, Rotman M, Schreiber D. Radiation therapy for clinically localized prostate cancer: long-term results of 469 patients from a single institution in the era of dose escalation. J Cancer Res Ther. 2014;10(4):951–6. doi: 10.4103/09731482.138096.
  2. Joshi CP, Dhanesar S, Darko J, Kerr A, Vidyasagar PB, Schreiner LJ. Practical and clinical considerations in Cobalt-60 tomotherapy. J Med Phys. 2009;34(3):137–40. doi: 10.4103/09716203.54847.
  3. Bagshaw MA, Ray GR, Pistenma DA, Castellino RA, Meares EM. External beam radiation therapy of primary carcinoma of the prostate. Cancer. 1975;36(2):723–8.
  4. Cupps RE, Utz DC, Fleming TR, Carson CC, Zincke H, Myers RP. Definitive radiation therapy for prostatic carcinoma: Mayo clinic experience. J Urol. 1980;124(6):855–9.
  5. Pilepich MV, Perez CA, Bauer W. Prognostic parameters in radiotherapeutic management of localized carcinoma of the prostate. J Urol. 1980;124(4):485–7.
  6. Mahadevan A, Bucholz R, Gaya AM, Kresl JJ, Mantz C, Minnich DJ, Muacevic A, Medbery C 3rd, Yang J, Caglar HB, Davis JN. Best of the Radiosurgery Society® Scientific Meeting 2014: stereotactic radiosurgery/stereotactic body radiotherapy treatment of extracranial and intracranial lesions. Future Oncol. 2014;10(15):2307–10. doi: 10.2217/fon.14.168.
  7. Hanks GE, Dunlap K. A comparison of the cost of various treatment methods for early cancer of the prostate. Int J Radiat Oncol Biol Phys. 1986;12(10):1879–81.
  8. Perez CA, Michalski J, Ballard S, Drzymala R, Kobeissi BJ, Lockett MA, Wasserman TH. Cost benefit of emerging technology in localized carcinoma of the prostate. Int J Radiat Oncol Biol Phys. 1997;39(4):875–83.
  9. Yu JB, Soulos PR, Herrin J, Cramer LD, Potosky AL, Roberts KB, Gross CP. Proton versus intensity-modulated radiotherapy for prostate cancer: patterns of care and early toxicity. J Natl Cancer Inst. 2013;105(1):25–32. doi: 10.1093/jnci/djs463.
  10. Hoskin PJ, Rojas AM, Bownes PJ, Lowe GJ, Ostler PJ, Bryant L. Randomised trial of external beam radiotherapy alone or combined with high-dose-rate brachytherapy boost for localised prostate cancer. Radiother Oncol. 2012;103(2):217–22. doi: 10.1016/j.radonc.2012.01.007.
  11. Hoffman RM, Barry MJ, Stanford JL, Hamilton AS, Hunt WC, Collins MM. Health outcomes in older men with localized prostate cancer: results from the Prostate Cancer Outcomes Study. Am J Med. 2006;119(5):418–25.
  12. Stattin P, Holmberg E, Johansson JE, Holmberg L, Adolfsson J, Hugosson J; National Prostate Cancer Register (NPCR) of Sweden. Outcomes in localized prostate cancer: National Prostate Cancer Register of Sweden follow-up study. J Natl Cancer Inst. 2010;102(13):950–8. doi: 10.1093/jnci/djq154.
  13. Fox C, Romeijn HE, Lynch B, Men C, Aleman DM, Dempsey JF. Comparative analysis of 60Co intensity-modulated radiation therapy. Phys Med Biol. 2008;53(12):3175–88. doi: 10.1088/0031-9155/53/12/007.
  14. Peeters ST, Heemsbergen WD, Koper PC, van Putten WL, Slot A, Dielwart MF, Bonfrer JM, Incrocci L, Lebesque JV. Dose-response in radiotherapy for localized prostate cancer: results of the Dutch multicenter randomized phase III trial comparing 68 Gy of radiotherapy with 78 Gy. J Clin Oncol. 2006;24(13):1990–6.
  15. Zhu Z, Zhang J, Liu Y, Chen M, Guo P, Li K. Efficacy and toxicity of external-beam radiation therapy for localised prostate cancer: a network meta-analysis. Br J Cancer. 2014;110(10):2396–404. doi: 10.1038/bjc.2014.197.
  16. Bian SX, Kuban DA, Levy LB, Oh J, Castle KO, Pugh TJ, Choi S, McGuire SE, Nguyen QN, Frank SJ, Nguyen PL, Lee AK, Hoffman KE. Addition of short-term androgen deprivation therapy to dose-escalated radiation therapy improves failure-free survival for select men with intermediate-risk prostate cancer. Ann Oncol. 2012;23(9):2346–52. doi: 10.1093/annonc/mds001.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2015 Balkanov A.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies