Prostate 86.4Gy plan with CFIMRT : Don't use in clinical plactice!

I made prostate 86.4Gy plan with the constraints of MSKCC. Unfortunately I cannot make a perfect plan, but I think this plan is within the allowable range. In a recent article, Cahlon and Zelefsky et. al. report that the results of 86.4Gy irradiation for prostate are not superior to results of 78-81Gy(1). So you should not use such high dose for prostate.

1. Cahlon O, Zelefsky MJ, et. al. Ultra-High Dose (86.4 Gy) IMRT for Localized Prostate Cancer: Toxicity and Biochemical Outcomes. Int J Radiat Oncol Biol Phys. 2007 (Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York.)

And please watch this PDF file.

combo vs imrt astro 2007 poster (from ASTRO 2007)

2. Zelefsky MJ, et al. Long-term Results of Conformal Radiotherapy for Prostate Cancer: Impact of Dose Escalation on Biochemical Tumor Control and Distant Metastases-Free Survival Outcomes. Int J Radiat Oncol Biol Phys. 2008 Feb 13 [Epub ahead of print]

 

Dose

5 years PSA control

7 years PSA control

70.2Gy

61%

50%

75.6Gy

74%

68%

  81Gy

85%

78%

86.4Gy

82%

66%

Global max : 92.34Gy

OAR: V47 (Bladder) : 64%     V47 (Rectum) : 41.5%    V75.6 (Rectum) : 12.1%

PTV:                            V100 : 78.3%            D95 : 80.1%

 

 

 

7 ports irradiation

last modification date: 2008/01/29