Department of Radiation Oncology, Mayo Clinic Arizona, Scottsdale, AZ.
To evaluate, in a prospective study, the use of (111)In-capromab pendetide (ProstaScint) scan to guide the delivery of a concomitant boost to intraprostatic region showing increased uptake while treating the entire gland with intensity-modulated radiotherapy for localized prostate cancer.
From September 2002 to November 2005, 71 patients were enrolled. Planning pelvic CT and (111)In-capromab pendetide scan images were coregistered. The entire prostate gland received 75.6 Gy/42 fractions, whereas areas of increased uptake in (111)In-capromab pendetide scan received 82 Gy. For patients with T3/T4 disease, or Gleason score ≥8, or prostate-specific antigen level >20 ng/mL, 12 months of adjuvant androgen deprivation therapy was given. In January 2005 the protocol was modified to give 6 months of androgen deprivation therapy to patients with a prostate-specific antigen level of 10-20 ng/mL or Gleason 7 disease.
Thirty-one patients had low-risk, 30 had intermediate-risk, and 10 had high-risk disease. With a median follow-up of 66 months, the 5-year biochemical control rates were 94% for the entire cohort and 97%, 93%, and 90% for low-, intermediate-, and high-risk groups, respectively. Maximum acute and late urinary toxicities were Grade 2 for 38 patients (54%) and 28 patients (39%) and Grade 3 for 1 and 3 patients (4%), respectively. One patient had Grade 4 hematuria. Maximum acute and late gastrointestinal toxicities were Grade 2 for 32 patients (45%) and 15 patients (21%), respectively. Most of the side effects improved with longer follow-up.
Concomitant boost to areas showing increased uptake in (111)In-capromab pendetide scan to 82 Gy using intensity-modulated radiotherapy while the entire prostate received 75.6 Gy was feasible and tolerable, with 94% biochemical control rate at 5 years.
Wong WW, Schild SE, Vora SA, Ezzell GA, Nguyen BD, Ram PC, Roarke MC. Are you the author?
Reference: Int J Radiat Oncol Biol Phys. 2011 Apr 6. Epub ahead of print.
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