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Front Oncol. 2015 Feb 2;5:18. doi: 10.3389/fonc.2015.00018. eCollection 2015.

Potential applications of image-guided radiotherapy for radiation dose escalation in patients with early stage high-risk prostate cancer.

Author information

1
Department of Radiation Oncology, Howard University , Washington, DC , USA.
2
Department of Radiation Oncology, Michael D. Wachtel Cancer Center , Oskosh, WI , USA.
3
Department of Radiation Oncology, Medicine and Radiation Oncology PA , San Antonio, TX , USA.
4
Department of Radiation Oncology, Martinique University Hospital , Martinique , France.
5
Department of Radiation Oncology, University of West Virginia , Morgantown, WV , USA.
6
Department of Radiation Oncology, Rochester Radiation Oncology Group , Rochester, NY , USA.
7
Department of Radiation Oncology, Akron City Hospital , Akron, OH , USA.
8
Department of Radiation Oncology, Richard A. Henson Institute , Salisbury, ML , USA.
9
Department of Radiation Oncology, Camden Clark Cancer Center , Parkersburg, WV , USA.
10
Department of Radiation Oncology, University Cancer Centers , Houston, TX , USA.
11
Department of Radiation Oncology, Marshfield Clinic , Marshfield, WI , USA.
12
University of Galveston School of Medicine , Galveston, TX , USA.
13
Department of Radiation Oncology, Geisel School of Medicine at Dartmouth, Dartmouth College , Hanover, NH , USA.

Abstract

Patients with early stage high-risk prostate cancer (prostate specific antigen > 20, Gleason score > 7) are at high risk of recurrence following prostate cancer irradiation. Radiation dose escalation to the prostate may improve biochemical-free survival for these patients. However, high rectal and bladder dose with conventional three-dimensional conformal radiotherapy may lead to excessive gastrointestinal and genitourinary toxicity. Image-guided radiotherapy (IGRT), by virtue of combining the steep dose gradient of intensity-modulated radiotherapy and daily pretreatment imaging, may allow for radiation dose escalation and decreased treatment morbidity. Reduced treatment time is feasible with hypo-fractionated IGRT and it may improve patient quality of life.

KEYWORDS:

high-risk; hypofractionation; image-guided radiotherapy; prostate cancer

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