A Prospective Study of Stereotactic Body Radiotherapy (SBRT) with Concomitant Whole-Pelvic Radiotherapy (WPRT) for High-Risk Localized Prostate Cancer Patients Using 1.5 Tesla Magnetic Resonance Guidance: The Preliminary Clinical Outcome
Abstract
:Simple Summary
Abstract
1. Introduction
2. Material and Methods
2.1. Patient Selection
2.2. Simulation Scan
2.3. Treatment Planning
2.4. Treatment Delivery and Adaptation
2.5. Patient Follow-Up and Outcome Measurements
2.6. Statistical Analysis
3. Results
3.1. Patient Selection and Baseline Characteristics
3.2. Treatment Delivery and Adaptation
3.3. Patient Follow-Up and Clinical Outcome
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Number of Patients | Percentage |
---|---|---|
Age (years) | ||
Mean ± SD | 72.5 ± 6.8 | |
Range | 59–90 | |
Prostate volume (cc) | ||
Mean ± SD | 53.5 ± 40.6 | |
PSA level (ng/mL) | ||
Median | 14.2 | |
Range | 1.46–866 | |
T Stage | ||
2a | 1 | 2.4% |
2b | 8 | 19.0% |
2c | 9 | 21.4% |
3a | 18 | 42.9% |
3b | 6 | 14.3% |
Pre-treatment Prostate-Specific Antigen (PSA) (ng/mL) | ||
<10 | 12 | 28.6% |
10–20 | 15 | 35.7% |
>20 | 15 | 35.7% |
Gleason score | ||
3 + 3 | 3 | 7.1% |
3 + 4 | 7 | 16.7% |
4 + 3 | 6 | 14.3% |
4 + 4 | 15 | 35.7% |
4 + 5 or 5 + 4 | 9 | 21.4% |
5 + 5 | 2 | 4.8% |
Rectal spacer | ||
Yes | 13 | 31.0% |
No | 29 | 69.0% |
Highest CTCAE Grade | Grade 0 | Grade 1 | Grade 2 | Grade 3 |
---|---|---|---|---|
GI Toxicity | ||||
Acute (during MRgSBRT and ≤30 days after MRgSBRT) | 78.6% (33/42) | 19.0% (8/42) | 2.4% (1/42) | 0 |
Subacute (>30 days after MRgSBRT to the last follow-up) | 76.2% (32/42) | 21.4% (9/42) | 2.4% (1/42) | 0 |
GU Toxicity | ||||
Acute (during MRgSBRT and ≤30 days after MRgSBRT) | 11.9% (5/42) | 81.0% (34/42) | 7.1% (3/42) | 0 |
Subacute (>30 days after MRgSBRT to the last follow-up) | 33.3% (14/42) | 64.3% (27/42) | 2.4% (1/42) | 0 |
Acute (≤30 Days) | Subacute (>30 Days) | |||||
---|---|---|---|---|---|---|
Grade 1 | Grade 2 | Grade 3 | Grade 1 | Grade 2 | Grade 3 | |
GI Toxicity | ||||||
Abdominal pain | 2 | 0 | 0 | 1 | 0 | 0 |
Bloating | 0 | 0 | 0 | 0 | 0 | 0 |
Constipation | 0 | 0 | 0 | 1 | 0 | 0 |
Diarrhea | 1 | 1 | 0 | 1 | 0 | 0 |
Fecal incontinence | 0 | 0 | 0 | 0 | 0 | 0 |
Nausea | 0 | 0 | 0 | 0 | 0 | 0 |
Proctitis | 2 | 0 | 0 | 1 | 0 | 0 |
Rectal hemorrhage | 1 | 0 | 0 | 6 | 1 | 0 |
Rectal pain | 2 | 0 | 0 | 0 | 0 | 0 |
GU Toxicity | ||||||
Urinary frequency | 31 | 1 | 0 | 25 | 1 | 0 |
Urinary incontinence | 4 | 0 | 0 | 1 | 0 | 0 |
Urinary retention | 1 | 0 | 0 | 1 | 0 | 0 |
Urinary tract pain | 16 | 2 | 0 | 3 | 0 | 0 |
Urinary urgency | 3 | 0 | 0 | 3 | 0 | 0 |
Time Points | |||||||
---|---|---|---|---|---|---|---|
Baseline * | 1–3 Month Follow-Up | 4–6 Month Follow-Up | 7–9 Month Follow-Up | 10–12 Month Follow-Up | >12 Month Follow-Up | p-Value | |
Patients (n) | 27 | 37 | 25 | 19 | 14 | 15 | NA |
Domain Summary Scores (median and range) | |||||||
Urinary | 89.58 [51.42 100.00] | 83.33 [29.17, 100.00] | 83.33 [59.75, 97.92] | 91.33 [53.50, 100.00] | 94.79 [62.50, 100.00] | 93.75 [67.33, 100.00] | 0.07 |
Bowel | 96.43 [75.00, 100.00] | 88.39 [42.31, 100.00] | 85.71 [66.07, 100.00] | 92.86 [73.21, 100.00] | 87.50 [67.86, 100.00] | 96.43 [69.64, 100.00] | 0.193 |
Sexual | 34.62 [7.69, 65.38] | 27.23 [0.00, 67.31] | 30.77 [0.00, 58.33] | 25.08 [0.00, 67.31] | 30.77 [0.00, 53.85] | 21.15 [0.00, 63.46] | 0.06 |
Hormonal | 95.45 [68.18, 100.00] | 88.64 [36.36, 100.00] | 93.18 [47.73, 100.00] | 86.36 [50.00, 100.00] | 85.57 [63.64, 100.00] | 90.91 [65.91, 100.00] | 0.40 |
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Poon, D.M.C.; Yuan, J.; Yang, B.; Wong, O.-L.; Chiu, S.-T.; Chiu, G.; Cheung, K.-Y.; Yu, S.-K.; Yung, R.W.H. A Prospective Study of Stereotactic Body Radiotherapy (SBRT) with Concomitant Whole-Pelvic Radiotherapy (WPRT) for High-Risk Localized Prostate Cancer Patients Using 1.5 Tesla Magnetic Resonance Guidance: The Preliminary Clinical Outcome. Cancers 2022, 14, 3484. https://doi.org/10.3390/cancers14143484
Poon DMC, Yuan J, Yang B, Wong O-L, Chiu S-T, Chiu G, Cheung K-Y, Yu S-K, Yung RWH. A Prospective Study of Stereotactic Body Radiotherapy (SBRT) with Concomitant Whole-Pelvic Radiotherapy (WPRT) for High-Risk Localized Prostate Cancer Patients Using 1.5 Tesla Magnetic Resonance Guidance: The Preliminary Clinical Outcome. Cancers. 2022; 14(14):3484. https://doi.org/10.3390/cancers14143484
Chicago/Turabian StylePoon, Darren M. C., Jing Yuan, Bin Yang, Oi-Lei Wong, Sin-Ting Chiu, George Chiu, Kin-Yin Cheung, Siu-Ki Yu, and Raymond W. H. Yung. 2022. "A Prospective Study of Stereotactic Body Radiotherapy (SBRT) with Concomitant Whole-Pelvic Radiotherapy (WPRT) for High-Risk Localized Prostate Cancer Patients Using 1.5 Tesla Magnetic Resonance Guidance: The Preliminary Clinical Outcome" Cancers 14, no. 14: 3484. https://doi.org/10.3390/cancers14143484