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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

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Published on: February 6, 2019

A Phase 1 Trial of Image Guided Risk Volume-Adapted Postprostatectomy Radiation Therapy.

Krishnan R Patel¹, Esther Mena², Lindsay S Rowe³

¹Radiation Oncology Branch, National Cancer Institute, National Institutes fo Health, Bethesda, Maryland.

International Journal of Radiation Oncology, Biology, Physics

|October 9, 2024

Summary

This summary is machine-generated.

The most compressed dose schedule (DS3) for hypofractionated, risk volume-adapted postoperative radiation therapy (PORT) was found tolerable for recurrent prostate cancer. This approach showed excellent biochemical progression-free survival with manageable side effects.

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Stereotactic Radiosurgery for Gynecologic Cancer

Stereotactic Radiosurgery for Gynecologic Cancer

Published on: April 17, 2012

Area of Science:

Radiation Oncology
Prostate Cancer Treatment
Clinical Trials

Background:

Biochemically recurrent prostate cancer requires effective treatment options.
Hypofractionated, risk volume-adapted postoperative radiation therapy (PORT) is being explored for improved outcomes.
Optimizing dose schedules is crucial for balancing efficacy and toxicity.

Purpose of the Study:

To identify the most compressed, tolerable dose schedule (DS) for risk volume-adapted, hypofractionated PORT in biochemically recurrent prostate cancer.
To evaluate secondary endpoints including biochemical progression-free survival and quality of life (QOL).

Main Methods:

A phase 1 trial utilizing a 3+3 dose escalation design with three isoeffective dose schedules (DS1: 20 fractions, DS2: 15 fractions, DS3: 10 fractions).
Dose escalation targeted the imaging-defined local recurrence while de-escalating to the prostate bed.
Toxicity was assessed using Common Terminology Criteria for Adverse Events (CTCAE) v.4.0, and QOL was measured using the Expanded Prostate Cancer Index Composite short form.

Main Results:

Fifteen patients were treated across the dose schedules, with expansion at DS3 (10 fractions) due to tolerability.
No dose-limiting toxicities were observed; cumulative incidence of Grade 3 GI and genitourinary toxicity was 7% and 9% at 24 months, respectively.
Biochemical progression-free survival was 91% at 24 and 60 months, with transient QOL declines that resolved by 24 months.

Conclusions:

The maximally tolerated hypofractionated dose schedule for risk volume-adapted PORT was DS3 (10 fractions).
This schedule delivered 36.4 Gy to the prostate bed and 47.1 Gy to the recurrence.
No Grade >3 events occurred, and transient QOL reductions did not persist, supporting DS3 as a viable option.