Clinical outcome and toxicity evaluation of simultaneous integrated boost pelvic IMRT/VMAT at different dose levels combined with androgen deprivation therapy in prostate cancer patients

Figures & data

Table 1 Patient’s criteria

Characteristics	All patients, N=24
Age (years)
Median	65
Range	51–86
Performance
0	16 (66.7%)
1	8 (33.3%)
Diabetic	13 (54.2%)
Anticoagulant therapy	4 (16.7%)
T stage
T1–T2	10 (41.6%)
T3–T4	14 (58.4%)
N stage
N0	20 (83.3%)
N1	4 (16.7%)
Gleason score
≤6	5 (20.9%)
7	8 (33.3%)
≥8	11 (45.8%)
Initial PSA (median, range)	18.8 (3–300)
<10	2 (8.3%)
10–20	11 (45.8%)
≥20	11 (45.8%)
Risk groups
Intermediate risk	5 (20.9%)
High risk	19 (79.1%)
Total dose (Gy)
70	4 (16.7%)
72	2 (8.3%)
74	4 (16.7%)
76	4 (16.7%)
80	10 (41.7%)
Hormonal therapy
Neoadjuvant	24 (100%)
Concomitant	21 (87.5%)
Adjuvant	19 (79.1%)

Abbreviation: PSA, prostate specific antigen.

Figure 1 Analysis of freedom from late rectal toxicity for dose level <76 versus ≥76 Gy.

Figure 2 Analysis of freedom from late genitourinary toxicity for dose level <76 versus ≥76 Gy.

Figure 3 Biochemical disease-free survival by dose level.

Figure 4 Metastasis-free survival by dose level.

Figure 5 Overall survival by dose level.

Table 2 Distribution of prognostic factors in patients according to treatment dose

Factor	Dose <76 Gy no of patients	%	Dose ≥76 Gy no of patients	%	P-value
Age group					0.7
<65 years	5	50	5	35.7
≥65 years	5	50	9	64.3
Performance					0.6
0	7	70	9	64.3
1	3	30	5	35.7
Stage					0.3
T1/T2	4	40	6	42.9
T3	6	60	8	57.1
N1	3	30	1	7.1
Gleason score					0.9
2–6	2	20	3	21.4
7	3	30	5	35.7
8–10	5	50	6	42.9
Pre-treatment P	SA				0.2
<10	0	0	2	14.3
10–20	9	90	12	85.7
≥20	1	10	0	0

Abbreviation: PSA, prostate specific antigen.

Table 3 Acute toxicity in relation to dose levels

Organs	Toxicity	Dose <76 Gy		Dose ≥76 Gy		P-value
		No	%	No	%
GI	Proctitis					0.1
	≤ GI	10	100	11	78.5
	G II	0		3	21.5
	Diarrhea					0.3
	≤ GI	6	60	9	64.3
	G II	4	40	5	35.7
GU	Dysuria					0.6
	≤ GI	8	80	8	57.2
	G II	2	20	6	42.9
	Frequency					0.2
	≤ GI	7	70	5	35.7
	G II	3	30	9	64.3
	Urgency					0.9
	≤ GI	9	90	12	85.7
	G II	1	10	2	14.3
	Incontinency					0.3
	≤ GI	10	100	13	92.9
	G II	0	0	1	7.1

Abbreviations: GI, gastrointestinal; GU, genitourinary.

Table 4 Overall grade II toxicity by treatment dose

Acute grade II toxicity	All patients 24	Dose <76 Gy N (%)	Dose ≥76 Gy N (%)	P-value
GI	10 (41.7%)	4 (40)	6 (42.9)	0.61
GU	15 (62.5%)	6 (60)	9 (64.3)	0.58

Abbreviations: GI, gastrointestinal; GU, genitourinary.