HYPOFRACTIONATED RADIOTHERAPY TO THE PROSTATE BED WITH INTENSITY MODULATED RADIATION THERAPY (IMRT): A PHASE II STUDY
Bibliographic record
Abstract
All articles of this category (opens in new window) Introduction: Prostate cancer (Pca) management can include radical prostatectomy (RP) plus or minus radiotherapy (RT). Post-operative, radiotherapy is prescribed in the adjuvant setting or in case of biochemical failure (salvage treatment). Historically, RT is delivered using conventional doses (1.82 Gy /day), to a total of 647OGy to the prostate surgical bed. Hypofractionated RT has been demonstrated to be safe and effective in the treatment of intact Pca, but RT use in the post-operative setting lack of high-quality evidence. The current study aims to evaluate the safety and effectiveness of hipofractionated RT in the post-operative setting (the prostate bed). Methods: This is an interim analysis (follow up and accrual not completed) of phase II trial of Pca patients submitted to RP and adjuvant or salvage RT. The radiation treatment was delivered using volumetric arch and image guided RT technique to a dose of 51 Gy in 15 fractions. The primary goal was to evaluate grade ≥ 2 acute urinary (GU) toxicity. Sample calculation was based on an incidence of GU toxicity of 15% with an calculated IC of 9% (6-24%). This resulted in a sample size of 61 patients. The study secondary objectives were biochemical recurrence free survival, metastasis free survival, time to hormone therapy, and overall survival. Additional objectives were gastrointestinal toxicities (GI), late GI and GU toxicities, and quality of life measurements, (using EPIC), before RT, 3, 6, 12 and 24 months after RT. Results: Sixty-one patients were enrolled in the study. Three percent presented with low risk, 13 % intermediate and 84% with high risk disease. Fifty six patients underwent salvage RT and 5 adjuvant RT. Average pre-treatment PSA was 0.27ng/mL (0.08-0.47). Median follow up is 8 months (2-23). The rate of grade ≥ 2 GU acute toxicity was 10.8% and 1 patient had urinary retention. Grade ≥ 2 acute GI toxicity rate was 13%. During follow up time, only 1 patient had biochemical failure and no distant metastasis. Post-RT PSA value diminished in 95.6% patients and average PSA value was 0.01 ng/mL (<0.003-1.18). All grades late GU, and GI toxicities rates were both 2.5%. Conclusions: In this interim analysis, hypofractionated RT to the prostate bed is reported to be a safe and effective strategy for Pca patients submitted to RP and adjuvant or salvage RT. Publication History Article published online: 23 October 2019 © 2019. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/) Thieme Revinter Publicações Ltda. Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Bibliographical Record Elton Trigo Teixeira Leite, Clarissa Cerchi Angotti Ramos, Bernardo Peres Salvajoli, João Victor Salvajoli, Fabio Ynoe de Moraes. HYPOFRACTIONATED RADIOTHERAPY TO THE PROSTATE BED WITH INTENSITY MODULATED RADIATION THERAPY (IMRT): A PHASE II STUDY. Brazilian Journal of Oncology 2019; 15. DOI: 10.1055/s-0044-1798306
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".