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Advancements in the radiooncological treatment of high-risk prostate cancer: a quarter century of achievements

Matthias Moll
Matthias Moll
, 
Harald Herrmann
Harald Herrmann
, 
Alexandru Zaharie
Alexandru Zaharie
 e 
Gregor Goldner
Gregor Goldner
   | 14 ago 2022
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Article Category: research article
Pubblicato online: 14 ago 2022
Pagine: 365 - 370
Ricevuto: 14 feb 2022
Accettato: 28 mar 2022
DOI: https://doi.org/10.2478/raon-2022-0018
© 2022 Matthias Moll, Harald Herrmann, Alexandru Zaharie, Gregor Goldner, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Biochemical no evidence of disease (bNED) rates in the 66 Gy, 74 Gy, and 78 Gy groups. The difference between the groups is highly significant (p < 0.0001).
Biochemical no evidence of disease (bNED) rates in the 66 Gy, 74 Gy, and 78 Gy groups. The difference between the groups is highly significant (p < 0.0001).

Figure 2

Onset of RTOG grade ≥2 gastrointestinal (GI) side effects after treatment over a follow-up period of 120 months.
Onset of RTOG grade ≥2 gastrointestinal (GI) side effects after treatment over a follow-up period of 120 months.

Figure 3

Onset of RTOG grade ≥ 2 genitourinary (GU) side effects after treatment over a follow-up period of 120 months.
Onset of RTOG grade ≥ 2 genitourinary (GU) side effects after treatment over a follow-up period of 120 months.

Maximum late side effects

GI late 0 1 2 3 GU late 0 1 2 3
78 Gy 62% 21% 13% 4% 78 Gy 49% 23% 23% 5%
74 Gy 63% 22% 13% 1% 74 Gy 53% 21% 22% 3%
66 Gy 66% 22% 12% 0% 66 Gy 54% 29% 15% 2%

Multivariate analysis of potential predictors of biochemical no evidence of disease (bNED)

Variable HR 95% CI p-value
iPSA (log2 transformed) 1.193 1.058–1.345 0.004
Gleason ≤ 6 or Histograding 1 reference
Gleason 7 or Histograding 2 1.254 0.797–1.890 0.280
Gleason 8-10 or Histograding 3 1.687 1.132–2.515 0.010
Pelvic irradiation 0.783 0.540–1.135 0.196
T stage ≤ 2a reference
T stage 2b/c 1.466 0.950-2.262 0.084
T stage 3/4 1.517 1.054-2.181 0.025
Dose (Gy) 0.928 0.890-0.969 < 0.001

Maximum acute side effects

GI acute 0 1 2 3 GU acute 0 1 2 3
78 Gy 11% 50% 39% 1% 78 Gy 13% 54% 32% 1%
74 Gy 35% 35% 29% 1% 74 Gy 19% 45% 34% 1%
66 Gy 38% 22% 40% 0% 66 Gy 25% 44% 30% 1%

Patient characteristics

Median Dose 78 Gy N = 141 74 Gy N = 282 66 Gy N = 142
Dose distribution in Gy
     Min 76 70.4 60
    Max 80 75 70
    N with median dose 127 90% 178 63% 83 58%
T category
    T1 43 30% 48 17% 21 15%
    T2 61 43% 108 38% 53 37%
    T3 36 26% 121 43% 60 42%
    T4 1 1% 5 2% 8 6%
Gleason score
    ≤6 or histological grading 1 20 14% 94 31% 40 11%
    7 or histological grading 2 29 21% 66 20% 52 4%
    8–10 or histol. grading 3 92 65% 118 42% 42 30%
    X 0 0% 4 1% 8 6%
iPSA in ng/ml
    Median 15.7 20.6 21
Technique
    3D-conformal 11 8% 281 100% 142 100%
    IMRT or VMAT 130 92% 1 0% 0 0%
    Inclusion of LN 133 94% 105 37% 15 11%
ADT 126 89% 259 92% 113 80%
    Mean in months 21 16 23
Follow-up in months
    Min 3 2 3
    Max 116 240 240
    Median 48 47 59
Age in years
    Min 49 51 53
    Max 84 86 93
    Median 75 73 71
Gold marker fiducials 53% 1% 0%
eISSN:
1581-3207
Lingua:
Inglese
Frequenza di pubblicazione:
4 volte all'anno
Argomenti della rivista:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
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