Potential applications of image-guided radiotherapy for radiation dose escalation in patients with early stage high-risk prostate cancer

Nam P Nguyen, Rick Davis, Satya R Bose, Suresh Dutta, Vincent Vinh-Hung, Alexander Chi, Juan Godinez, Anand Desai, William Woods, Gabor Altdorfer, Mark D'Andrea, Ulf Karlsson, Richard A Vo, Thomas Sroka, International Geriatric Radiotherapy Group, Nam P Nguyen, Rick Davis, Satya R Bose, Suresh Dutta, Vincent Vinh-Hung, Alexander Chi, Juan Godinez, Anand Desai, William Woods, Gabor Altdorfer, Mark D'Andrea, Ulf Karlsson, Richard A Vo, Thomas Sroka, International Geriatric Radiotherapy Group

Abstract

Patients with early stage high-risk prostate cancer (prostate specific antigen > 20, Gleason score > 7) are at high risk of recurrence following prostate cancer irradiation. Radiation dose escalation to the prostate may improve biochemical-free survival for these patients. However, high rectal and bladder dose with conventional three-dimensional conformal radiotherapy may lead to excessive gastrointestinal and genitourinary toxicity. Image-guided radiotherapy (IGRT), by virtue of combining the steep dose gradient of intensity-modulated radiotherapy and daily pretreatment imaging, may allow for radiation dose escalation and decreased treatment morbidity. Reduced treatment time is feasible with hypo-fractionated IGRT and it may improve patient quality of life.

Keywords: high-risk; hypofractionation; image-guided radiotherapy; prostate cancer.

References

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