Treatment outcome of localized prostate cancer using transperineal ultrasound image-guided radiotherapy

IF 3.3 2区医学 Q2 ONCOLOGY

Radiation Oncology Pub Date : 2024-08-01 DOI:10.1186/s13014-024-02490-x

Kenji Takai, Ryota Watanabe, Ken-ichi Hyogo, Yuri Ito, Nobuko Minagawa, Yusuke Sato, Yoshikazu Matsuda, Kenji Nemoto

{"title":"Treatment outcome of localized prostate cancer using transperineal ultrasound image-guided radiotherapy","authors":"Kenji Takai, Ryota Watanabe, Ken-ichi Hyogo, Yuri Ito, Nobuko Minagawa, Yusuke Sato, Yoshikazu Matsuda, Kenji Nemoto","doi":"10.1186/s13014-024-02490-x","DOIUrl":null,"url":null,"abstract":"We report the results of a retrospective analysis of localized prostate cancer (LPCa) treated with transperineal ultrasound image-guided radiotherapy (TPUS-IGRT). A total of 124 patients (median age: 74 y, 46–84 y) with LPCa who underwent TPUS-IGRT (Clarity Autoscan system; CAS, Elekta; Stockholm, Sweden) between April 2016 and October 2021 for curative/after hormone induction were enrolled. The number of patients by risk (National Comprehensive Cancer Network 2019) was 7, 25, 42, and 50 for low (LR), good intermediate (good IR), poor intermediate (poor IR), and high (HR)/very high (VHR), respectively. Ninety-five patients were given neoadjuvant hormonal therapy. The planning target volume margin setting was 3 mm for rectal in most cases, 5–7 mm for superior/inferior, and 5 mm for anterior/right/left. The principle prescribed dose is 74 Gy (LR), 76 Gy (good IR), and 76–78 Gy (poor IR or above). CAS was equipped with a real-time prostate intrafraction monitoring (RTPIFM) system. When a displacement of 2–3 mm or more was detected, irradiation was paused, and the patients were placed on standby for prostate reinstatement/recorrection. Of the 3135 fractions in 85 patients for whom RTPIFM was performed, 1008 fractions (32.1%) were recorrected at least once after starting irradiation. A total of 123 patients completed the radiotherapy course. The 5-year overall survival rate was 95.9%. The 5-year biological prostate-specific antigen relapse-free survival rate (bPFS) was 100% for LR, 92.9% for intermediate IR, and 93.2% for HR/VHR (Phoenix method). The 5-year late toxicity rate of Grade 2+ was 7.4% for genitourinary (GU) and 6.5% for gastrointestinal (GI) organs. Comparing the ≤ 76 Gy group to the 78 Gy group for both GU and GI organs, the incidence was higher in the 78 Gy group for both groups. These results suggest that TPUS-IGRT is well tolerated, as the bPFS and incidence of late toxicity are almost comparable to those reported by other sources of image-guided radiotherapy.","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiation Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13014-024-02490-x","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

We report the results of a retrospective analysis of localized prostate cancer (LPCa) treated with transperineal ultrasound image-guided radiotherapy (TPUS-IGRT). A total of 124 patients (median age: 74 y, 46–84 y) with LPCa who underwent TPUS-IGRT (Clarity Autoscan system; CAS, Elekta; Stockholm, Sweden) between April 2016 and October 2021 for curative/after hormone induction were enrolled. The number of patients by risk (National Comprehensive Cancer Network 2019) was 7, 25, 42, and 50 for low (LR), good intermediate (good IR), poor intermediate (poor IR), and high (HR)/very high (VHR), respectively. Ninety-five patients were given neoadjuvant hormonal therapy. The planning target volume margin setting was 3 mm for rectal in most cases, 5–7 mm for superior/inferior, and 5 mm for anterior/right/left. The principle prescribed dose is 74 Gy (LR), 76 Gy (good IR), and 76–78 Gy (poor IR or above). CAS was equipped with a real-time prostate intrafraction monitoring (RTPIFM) system. When a displacement of 2–3 mm or more was detected, irradiation was paused, and the patients were placed on standby for prostate reinstatement/recorrection. Of the 3135 fractions in 85 patients for whom RTPIFM was performed, 1008 fractions (32.1%) were recorrected at least once after starting irradiation. A total of 123 patients completed the radiotherapy course. The 5-year overall survival rate was 95.9%. The 5-year biological prostate-specific antigen relapse-free survival rate (bPFS) was 100% for LR, 92.9% for intermediate IR, and 93.2% for HR/VHR (Phoenix method). The 5-year late toxicity rate of Grade 2+ was 7.4% for genitourinary (GU) and 6.5% for gastrointestinal (GI) organs. Comparing the ≤ 76 Gy group to the 78 Gy group for both GU and GI organs, the incidence was higher in the 78 Gy group for both groups. These results suggest that TPUS-IGRT is well tolerated, as the bPFS and incidence of late toxicity are almost comparable to those reported by other sources of image-guided radiotherapy.

查看原文本刊更多论文

经会阴超声图像引导放射治疗局部前列腺癌的疗效

我们报告了对采用经会阴超声图像引导放疗（TPUS-IGRT）治疗局部前列腺癌（LPCa）的回顾性分析结果。2016年4月至2021年10月期间，共有124名LPCa患者（中位年龄：74岁，46-84岁）接受了TPUS-IGRT（Clarity Autoscan系统；CAS，Elekta；瑞典斯德哥尔摩）治疗/激素诱导后治疗。按风险（美国国立综合癌症网络 2019）划分，低风险（LR）、良好中间风险（良好 IR）、较差中间风险（较差 IR）和高风险（HR）/极高风险（VHR）的患者人数分别为 7、25、42 和 50 人。95名患者接受了新辅助激素治疗。大多数病例的计划目标体积边缘设置为直肠3毫米，上/下5-7毫米，前/右/左5毫米。处方剂量原则上为 74 Gy（LR）、76 Gy（良好 IR）和 76-78 Gy（不良 IR 或以上）。CAS 配备了实时前列腺腔内分量监测（RTPIFM）系统。当检测到2-3毫米或更大的移位时，就会暂停照射，让患者处于前列腺复位/校正待命状态。在 85 位接受 RTPIFM 治疗的患者的 3135 个分段中，有 1008 个分段（32.1%）在开始照射后至少进行了一次重新校正。共有123名患者完成了放疗疗程。5年总生存率为95.9%。LR患者的5年生物前列腺特异抗原无复发生存率（bPFS）为100%，中期IR患者为92.9%，HR/VHR患者为93.2%（凤凰法）。泌尿生殖系统（GU）和胃肠道（GI）器官的5年晚期2级以上毒性率分别为7.4%和6.5%。在泌尿生殖器官和消化道器官方面，≤76 Gy 组与 78 Gy 组相比，78 Gy 组的发生率均较高。这些结果表明，TPUS-IGRT 的耐受性良好，因为其 bPFS 和晚期毒性发生率几乎与其他影像引导放疗的报道相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Radiation Oncology ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

6.50

自引率

2.80%

发文量

181

审稿时长

3-6 weeks

期刊介绍： Radiation Oncology encompasses all aspects of research that impacts on the treatment of cancer using radiation. It publishes findings in molecular and cellular radiation biology, radiation physics, radiation technology, and clinical oncology.

文献相关原料

公司名称	产品信息	采购帮参考价格