Hypofractionated intensity-modulated arc therapy for lymph node metastasized prostate cancer

Area of Science:

• Radiation Oncology
• Urologic Oncology
• Medical Physics

Background:

• Prostate cancer with lymph node metastasis (N1) requires effective primary treatment strategies.
• Hypofractionated radiotherapy aims to deliver higher doses per fraction, potentially improving treatment efficiency.
• Intensity-modulated arc radiotherapy (IMRT) allows for precise dose delivery, sparing surrounding tissues.

Purpose of the Study:

• To evaluate the planning outcomes of hypofractionated intensity-modulated arc radiotherapy (H-IMRT) combined with androgen deprivation therapy (ADT).
• To assess the acute toxicity profile of this combined treatment in patients with N1 prostate cancer.
• To determine the feasibility of H-IMRT and ADT as a primary treatment for lymph node-metastased prostate cancer.

Main Methods:

• Thirty-one patients with Stage T1-T4N1M0 prostate cancer received H-IMRT and 3-year ADT.
• Clinical target volumes (CTVs) for the prostate, seminal vesicles, and elective lymph nodes were defined.
• Planning target volumes (PTVs) were created with a 7 mm expansion; doses of 69.3 Gy (PTVp) and 50 Gy (PTVe) in 25 fractions were prescribed.

Main Results:

• Median follow-up was 3 months.
• No acute Grade 2 or higher gastrointestinal toxicity was observed.
• Acute Grade 2 genitourinary toxicity occurred in 14 patients, and Grade 3 in 2 patients.

Conclusions:

• Hypofractionated intensity-modulated arc radiotherapy combined with androgen deprivation is a feasible primary treatment for N1 prostate cancer.
• The treatment regimen demonstrated a low overall toxicity profile.
• This approach offers a potentially effective strategy for managing lymph node-metastased prostate cancer.