The impact of image guided external beam radiotherapy on outcome in treating intermediate risk cancer prostate | ||||
| SECI Oncology Journal | ||||
| Volume 11, Issue 1, January 2023, Page 40-53 | ||||
| DOI: 10.21608/secioj.2023.290767 | ||||
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| Abstract | ||||
| Background: Intermediate-risk prostate cancer is a highly heterogeneous disease. Treatment options include various radiotherapy techniques with a short course of androgen deprivation therapy (ADT), or combination external beam radiotherapy (EBRT) with a brachytherapy (BT) boost with or without ADT. The benefits of image guided radiotherapy (IGRT) have been shown in retrospective series and it has become the standard of care for delivery of external beam radiation treatment for prostate cancer. Purpose of the study: To compare the biochemical and clinical tumor control in patients treated by means of high dose IGRT versus high dose non image guided (non IG EBRT) as well as the toxicity profile in both techniques. Patients and Methods: This is a retrospective study that enrolled patients with localized cancer prostate of intermediate risk treated with EBRT either with or without image guidance between 1995 and 2012. Results: A cohort of 388 consecutive patients was enrolled. IGRT achieved significantly longer biochemical failure free survival (p = 0.016) only patients with favorable criteria have gained this advantage (p=0.055). T1C, total Gleason score 6, percent of positive biopsy cores ≤ 50% gained significantly longer bFFS compared with other subgroups. Concerning distant failure, IGRT, percent of positive biopsy cores ≤ 50%, favorable criteria and T1C were significantly associated with longer DFFS. ADT with radiotherapy showed significantly lower DFFS rates. Only total Gleason score that significantly has affected the local failure free survival (LFFS). Conclusions: Prostate cancer with unfavorable intermediate risk should ideally be treated with dose escalated IGRT with more longer treatment of ADT. | ||||
| Keywords | ||||
| Intermediate-risk prostate cancer; highly heterogeneous disease | ||||
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