High-Dose Image-Guided IMRT for treating localized prostate cancer is Effective in a Medium Term Evaluation

July 10, 2012 by  
Filed under Prostate Cancer News

Localized prostate cancer is that which still resides within the confines of the prostate gland. This type of prostate cancer can be successfully treated using surgical methods and radiation treatments.

One type of radiation treatment that has shown to be highly effective is the Intensity-Modulated Radio Therapy (IMRT).

Recently, a study was conducted in Japan to evaluate the medium-term treatment outcome for a patient who has been administered with high-dose IMRT using   intra-prostate fiducial markers for localized prostate cancer. Here are more details on this study and conclusion reached:

Several studies have confirmed the advantages of delivering high doses of external beamradiotherapy to achieve optimal tumor-control outcomes in patients with localized prostatecancer. We evaluated the medium-term treatment outcome after high-dose, image-guidedintensity-modulated radiotherapy (IMRT) using intra-prostate fiducial markers for clinicallylocalized prostate cancer.

Methods: In total, 141 patients with localized prostate cancer treated with image-guided IMRT (76Gyin 13 patients and 80Gy in 128 patients) between 2003 and 2008 were enrolled in this study.The patients were classified according to the National Comprehensive Cancer Networkdefinedrisk groups.

Thirty-six intermediate-risk patients and 105 high-risk patients wereincluded. Androgen-deprivation therapy was performed in 124 patients (88%) for a median of11months (range: 2-88 months).

Prostate-specific antigen (PSA) relapse was definedaccording to the Phoenix-definition (i.e ., an absolute nadir plus 2 ng/ml dated at the call). The5-year actuarial PSA relapse-free survival, the 5-year distant metastasis-free survival, the 5-year cause-specific survival (CSS), the 5-year overall survival (OS) outcomes and the acuteand late toxicities were analyzed.

The toxicity data were scored according to the CommonTerminology Criteria for Adverse Events, version 4.0. The median follow-up was 60 months.

Results: The 5-year PSA relapse-free survival rates were 100% for the intermediate-risk patients and82.2% for the high-risk patients; the 5-year actuarial distant metastasis-free survival rateswere 100% and 95% for the intermediate- and high-risk patients, respectively; the 5-year CSSrates were 100% for both patient subsets; and the 5-year OS rates were 100% and 91.7% forthe intermediate- and high-risk patients, respectively.

The Gleason score (<8 vs. [greater than or equal to]8) wassignificant for the 5-year PSA relapse-free survival on multivariate analysis (p=0.044).

Therewas no grade 3 or 4 acute toxicity. The incidence of grade 2 acute gastrointestinal (GI) andgenitourinary (GU) toxicities were 1.4% and 8.5%, respectively.

The 5-year actuariallikelihood of late grade 2-3 GI and GU toxicities were 6% and 6.3%, respectively. No grade4 GI or GU late toxicity was observed.

Conclusions: These medium-term results demonstrate a good tolerance of high-dose image-guided IMRT.However, further follow-up is needed to confirm the long-term treatment outcomes.  Source

The above extract is quite revealing and instructive. It is a good thing to know that the medium term evaluation yielded positive results. Although follow-up study is needed to confirm the long term result, the outcome can be predicted.

Hopefully, the effectiveness of this treatment in the long-term will be confirmed and those living with prostate cancer will enjoy a more effective treatment of their condition. Kudos should be given to the effort of this single Institute in Japan.

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