Volumetric Modulated Arc Therapy of the Pelvic Lymph Nodes to the Aortic Bifurcation in Higher Risk Prostate Cancer: Early Toxicity Outcomes.

Background. Treatment of pelvic lymph nodes (PLNs) in higher risk prostate carcinoma is controversial. The primary focus of the study was to evaluate the early toxicity profile for this cohort of patients treated with Volumetric Modulated Arc Therapy (VMAT).

Methods. Patient, tumour, and treatment characteristics of those who received VMAT from May 2010 to December 2012 were analysed. A simplified contouring process of the PLNs to the aortic bifurcation was developed based on consensus guidelines. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities were documented according to the Radiation Therapy Oncology Group (RTOG) Version 2 Guidelines. Successive Prostate Specific Antigen (PSA) values after treatment were measured on average 3 months apart. Results. 113 patients were treated between May 2010 to December 2012 with a median follow-up of 14 months. No patients experienced acute grade 3 or 4 GU and GI toxicity. Only 1 patient experienced a late grade 3 GU complication. No late grade 4 GU or GI events have yet occurred. Conclusions. This study reviews the first Australian experience of VMAT in the treatment of pelvic lymph nodes in prostate cancer, specifically to the level of the aortic bifurcation. It demonstrates a favorable acute toxicity profile whilst treating large PLN volumes with optimal dose coverage.

BioMed research international. 2015 Oct 11 [Epub]

Gina Hesselberg, Gerald Fogarty, Lauren Haydu, Nicole Dougheney, Phillip Stricker

Prince of Wales Hospital, High Street, Randwick, NSW 2031, Australia ; University of New South Wales, High Street, Kensington, NSW 2052, Australia. , Genesis Cancer Care, Mater Sydney Radiation Oncology, 25 Rocklands Road, Crows Nest, NSW 2065, Australia ; University of Texas MD Anderson Cancer Center, Surgical Oncology, 1400 Pressler Street, FCT 17. 6000, Houston, TX, USA ; St Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW 2010, Australia. , University of Texas MD Anderson Cancer Center, Surgical Oncology, 1400 Pressler Street, FCT 17. 6000, Houston, TX, USA. , Genesis Cancer Care, Mater Sydney Radiation Oncology, 25 Rocklands Road, Crows Nest, NSW 2065, Australia. , St Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW 2010, Australia.

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