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Hindi Research Article
Early Outcome of Prostate Intensity Modulated Radiation Therapy (IMRT) Incorporating a Simultaneous Intra-Prostatic MRI Directed Boost
| Michael H Schild, Steven E Schild*, William W Wong, Sujay A Vora, Alvin C Silva, Annelise M Silva, Thomas B Daniels and Sameer R Keole | |
| Department of Radiation Oncology, Mayo Clinic Arizona, Scottsdale 85259, USA | |
| Corresponding Author : | Steven E Schild Mayo Clinic, 13400 E. Shea Blvd Scottsdale, AZ 85259, USA Tel: 480-301-8000 Fax: 480-342-3972 E-mail: sschild@mayo.edu |
| Received October 20, 2014; Accepted November 17, 2014; Published November 20, 2014 | |
| Citation: Schild SE, Schild MH, Wong WW, Vora SA, Silva AC, et al. (2014) Early Outcome of Prostate Intensity Modulated Radiation Therapy (IMRT) Incorporating a Simultaneous Intra-Prostatic MRI Directed Boost. OMICS J Radiol 3:170. doi: 10.4172/2167-7964.1000170 | |
| Copyright: © 2014 Schild SE, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | |
Abstract
This study assessed the feasibility and outcomes of treating prostate cancer with intensity modulated radiotherapy (IMRT) incorporating a Magnetic Resonance Imaging (MRI) directed boost. Seventy-eight men received IMRT for localized prostate cancer. The entire prostate received 77.4Gy in 43 fractions and simultaneous intra-prostatic boosts (SIB) of 83Gy were administered to increase the dose to the MRI identified malignancy. In 16 (21%) patients, the MRI didn’t detect a neoplasm and these patients received an SIB of 81Gy to the posterior prostate. Androgen Deprivation Therapy (ADT) was also administered to 32 (41%) patients. The 3-year rates of biochemical control, local control, distant control, and survival were 92%, 98%, 95%, and 95% respectively. While grade 1-2 toxicities were common, there were only 2 patients who suffered grade 3 toxicity. These patients developed strictures which were dilated resulting in improvement in symptoms such that both had grade 1-2 toxicity at last follow up examination. The results of this program of IMRT incorporating a MRI directed intra-prostatic boost suggest this technique is feasible and well tolerated. This technique appears to shift the therapeutic index favorably by boosting the malignancy to the highest dose without increasing the doses administered to the bladder and rectum.
