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Elective node irradiation with integrated boost to the prostate using helical IMRT: clinical outcome of the prospective PLATIN-1 trial

Introduction: This prospective, non-randomized phase II trial aimed to investigate the role of additional irradiation of the pelvic nodes for patients with prostate cancer and a high risk for nodal metastases using helical intensity-modulated radiotherapy with daily image guidance (IMRT/IGRT). Metho...

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Main Authors: Körber, Stefan A. (Author) , Winter, Erik (Author) , Katayama, Sonja (Author) , Slynko, Alla (Author) , Häfner, Matthias (Author) , Uhl, Matthias (Author) , Sterzing, Florian (Author) , Habl, Gregor (Author) , Schubert, Kai (Author) , Debus, Jürgen (Author) , Herfarth, Klaus (Author)
Format: Article (Journal)
Language:English
Published: 13 August 2019
In: Frontiers in oncology
Year: 2019, Volume: 9
ISSN:2234-943X
DOI:10.3389/fonc.2019.00751
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3389/fonc.2019.00751
Verlag, kostenfrei, Volltext: https://www.frontiersin.org/articles/10.3389/fonc.2019.00751/full
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Author Notes:Stefan Alexander Koerber, Erik Winter, Sonja Katayama, Alla Slynko, Matthias Felix Haefner, Matthias Uhl, Florian Sterzing, Gregor Habl, Kai Schubert, Juergen Debus and Klaus Herfarth
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Summary:Introduction: This prospective, non-randomized phase II trial aimed to investigate the role of additional irradiation of the pelvic nodes for patients with prostate cancer and a high risk for nodal metastases using helical intensity-modulated radiotherapy with daily image guidance (IMRT/IGRT). Methods and materials: Between 2009 and 2012, 40 men with treatment-naïve prostate cancer and a risk of lymph node involvement of more than 20% were enrolled in the PLATIN-1 trial. All patients received definitive, helical IMRT of the pelvic nodes (total dose of 51.0 Gy) with a simultaneous integrated boost (SIB) to the prostate (total dose of 76.5 Gy) in 34 fractions. Antihormonal therapy (AHT) was administered for a minimum of two months before radiotherapy continuing for at least 24 months. Results: After a median follow-up of 71 months (range: 5 - 95 months), pelvic irradiation was associated with a 5-year overall survival (OS) and biochemical progression-free survival (bPFS) of 94.3% and 83.6%, respectively. For our cohort, no grade 4 gastrointestinal (GI) and genitourinary (GU) toxicity was observed. Quality of life (QoL) assessed by EORTC QLQ-C30 questionnaire was comparable to EORTC reference values without significant changes. Conclusion: The current trial demonstrates that elective IMRT/IGRT of the pelvic nodes with SIB to the prostate for patients with a high-risk of lymphatic spread is safe and shows an excellent clinical outcome without compromising the quality of life. The PLATIN-1 trial delivers eminent baseline data for future studies using modern irradiation techniques.
Item Description:Gesehen am 09.10.2019
Physical Description:Online Resource
ISSN:2234-943X
DOI:10.3389/fonc.2019.00751

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