In a nutshell
This article investigated the toxicity of intensity-modulated radiation therapy (IMRT) to the prostate and pelvic lymph nodes (PPLN-IMRT) compared with prostate-only (PO-IMRT) in high-risk prostate cancer (PC).
The authors concluded that both treatments had similar toxicity rates in these patients.
Some background
Locally advanced PC is cancer that has spread outside of the prostate gland into nearby tissues. The current treatment includes IMRT (uses precise radiation beams to kill cancer cells and limit the effects on the surrounding healthy tissues). IMRT can be delivered to the prostate only (PO) or to the lymph nodes (LN) also. This helps prevent the spread of cancer from the prostate LN to other LN.
It is not known if PO-IMRT is sufficient treatment in patients with high-risk PC. Also, it is not known if by using prostate and pelvic NL-IMRT (PPLN-IMRT) increases the side effects of this treatment.
Methods & findings
The study involved 3,845 male patients. They were divided into two groups. Group 1 received PPLN-IMRT (780) and group 2 received PO-IMRT (3,065). Gastrointestinal (GI) complications and genitourinary (GU) complications were compared between the two groups.
After 3 years, GI toxicity was 14% in both groups. GU toxicity was similar in group 1 (9%) and group 2 (8%). There was no significant difference in serious toxicity rates between the two groups.
The bottom line
The authors concluded that PPLN-IMRT has similar toxicity rates to PO-IMRT in patients with high-risk prostate cancer.
The fine print
This study had a short follow-up period. Longer-term studies are needed.
Published By :
Journal of clinical oncology
Date :
Jun 04, 2019
