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Multi-Institutional Phase II Study of Proton Beam Therapy for Organ-Confined Prostate Cancer Focusing on the Incidence of Late Rectal Toxicities

Nihei, Keiji, M.D., Ph.D ; Ogino, Takashi, M.D., Ph.D ; Onozawa, Masakatsu, M.D ; Murayama, Shigeyuki, M.D., Ph.D ; Fuji, Hiroshi, M.D., Ph.D ; Murakami, Masao, M.D., Ph.D ; Hishikawa, Yoshio, M.D., Ph.D

International journal of radiation oncology, biology, physics, 2011-10, Vol.81 (2), p.390-396 [Periódico revisado por pares]

New York, NY: Elsevier Inc

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Título:
Multi-Institutional Phase II Study of Proton Beam Therapy for Organ-Confined Prostate Cancer Focusing on the Incidence of Late Rectal Toxicities
Autor: Nihei, Keiji, M.D., Ph.D ; Ogino, Takashi, M.D., Ph.D ; Onozawa, Masakatsu, M.D ; Murayama, Shigeyuki, M.D., Ph.D ; Fuji, Hiroshi, M.D., Ph.D ; Murakami, Masao, M.D., Ph.D ; Hishikawa, Yoshio, M.D., Ph.D
Assuntos: Aged ; Aged, 80 and over ; ANTIGENS ; BEAMS ; Biological and medical sciences ; BLADDER ; BODY ; Clinical trial ; CLINICAL TRIALS ; DIGESTIVE SYSTEM ; DISEASES ; DOSES ; GASTROINTESTINAL TRACT ; GLANDS ; Gynecology. Andrology. Obstetrics ; Hematology, Oncology and Palliative Medicine ; HORMONES ; Humans ; Incidence ; INTESTINES ; LARGE INTESTINE ; Male ; Male genital diseases ; MALE GENITALS ; Medical sciences ; MEDICINE ; Middle Aged ; Neoplasm Staging ; NEOPLASMS ; Nephrology. Urinary tract diseases ; NUCLEAR MEDICINE ; NUCLEON BEAMS ; ORGANS ; PARTICLE BEAMS ; Prospective Studies ; PROSTATE ; Prostate cancer ; Prostate-Specific Antigen - blood ; Prostatic Neoplasms - blood ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - radiotherapy ; Proton beam therapy ; PROTON BEAMS ; Protons - adverse effects ; Protons - therapeutic use ; RADIATION DOSE DISTRIBUTIONS ; RADIATION DOSES ; Radiation Injuries - complications ; Radiation Injuries - epidemiology ; Radiation Injuries - pathology ; RADIOLOGY ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Rectal Diseases - etiology ; Rectal toxicity ; RECTUM ; Rectum - radiation effects ; TESTING ; THERAPY ; TOXICITY ; Tumors ; Tumors of the urinary system ; Urinary Bladder - radiation effects ; URINARY TRACT ; Urinary tract. Prostate gland ; Urination Disorders - etiology
É parte de: International journal of radiation oncology, biology, physics, 2011-10, Vol.81 (2), p.390-396
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
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Descrição: Purpose Proton beam therapy (PBT) is theoretically an excellent modality for external beam radiotherapy, providing an ideal dose distribution. However, it is not clear whether PBT for prostate cancer can clinically control toxicities. The purpose of the present study was to estimate prospectively the incidence of late rectal toxicities after PBT for organ-confined prostate cancer. Methods and Materials The major eligibility criteria included clinical Stage T1-T2N0M0; initial prostate-specific antigen level of ≤20 ng/mL and Gleason score ≤7; no hormonal therapy or hormonal therapy within 12 months before registration; and written informed consent. The primary endpoint was the incidence of late Grade 2 or greater rectal toxicity at 2 years. Three institutions in Japan participated in the present study after institutional review board approval from each. PBT was delivered to a total dose of 74 GyE in 37 fractions. The patients were prospectively followed up to collect the data on toxicities using the National Cancer Institute-Common Toxicity Criteria, version 2.0. Results Between 2004 and 2007, 151 patients were enrolled in the present study. Of the 151 patients, 75, 49, 9, 17, and 1 had Stage T1c, T2a, T2b, T2c, and T3a, respectively. The Gleason score was 4, 5, 6, and 7 in 5, 15, 80 and 51 patients, respectively. The initial prostate-specific antigen level was <10 or 10–20 ng/mL in 102 and 49 patients, respectively, and 42 patients had received hormonal therapy and 109 had not. The median follow-up period was 43.4 months. Acute Grade 2 rectal and bladder toxicity temporarily developed in 0.7% and 12%, respectively. Of the 147 patients who had been followed up for >2 years, the incidence of late Grade 2 or greater rectal and bladder toxicity was 2.0% (95% confidence interval, 0–4.3%) and 4.1% (95% confidence interval, 0.9–7.3%) at 2 years, respectively. Conclusion The results of the present prospective study have revealed a valuable piece of evidence that PBT for localized prostate cancer can achieve a low incidence of late Grade 2 or greater rectal toxicities.
Editor: New York, NY: Elsevier Inc
Idioma: Inglês

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Multi-Institutional Phase II Study of Proton Beam Therapy for Organ-Confined Prostate Cancer Focusing on the Incidence of Late Rectal Toxicities

Nihei, Keiji, M.D., Ph.D ; Ogino, Takashi, M.D., Ph.D ; Onozawa, Masakatsu, M.D ; Murayama, Shigeyuki, M.D., Ph.D ; Fuji, Hiroshi, M.D., Ph.D ; Murakami, Masao, M.D., Ph.D ; Hishikawa, Yoshio, M.D., Ph.D

New York, NY: Elsevier Inc

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