Locally advanced prostatic cancer: long-term toxicity outcome after three-dimensional conformal radiation therapy--a dose-escalation study

Radiology. 1998 Oct;209(1):169-74. doi: 10.1148/radiology.209.1.9769828.


Purpose: To determine the long-term effects of 75.6- and 81.0-Gy doses of three-dimensional conformal radiation therapy in a dose-escalation study in patients with stage T2c-T3 prostatic cancer.

Materials and methods: Fifty patients received an initial 75.6-Gy dose, and the dose in 46 patients was subsequently escalated to 81.0-Gy. Median follow-up was 60 and 40 months, respectively.

Results: The rates of effects of acute toxicity during the course of treatment were similar for both dose levels. Among the 96 patients, the rate of grade 2 morbidities necessitating medication to relieve acute symptoms was 17% (16 patients) for rectal and 36% (35 patients) for urinary morbidities. All other patients had either no or grade 1 morbidities. Fourteen patients (15%) developed late grade 2 rectal morbidities. There were no differences in 5-year actuarial rates of late grade 2 rectal or urinary morbidities among patients who received 75.6 Gy versus those who received 81.0 Gy. One patient treated with 81.0 Gy developed a grade 3 urethral stricture, which was resolved with dilatation.

Conclusion: Tumor dose escalation beyond conventional radiation doses for localized prostatic cancer is feasible when delivered with three-dimensional conformal radiation therapy, with no increase in morbidity in normal tissue.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase I
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Actuarial Analysis
  • Chemotherapy, Adjuvant
  • Follow-Up Studies
  • Humans
  • Male
  • Prospective Studies
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / radiotherapy*
  • Radiotherapy Dosage
  • Radiotherapy, Conformal / adverse effects*
  • Radiotherapy, Conformal / methods
  • Radiotherapy, Conformal / statistics & numerical data
  • Time Factors
  • Treatment Outcome