The Radiation Oncology Program continues to work toward its mission of providing innovative and sophisticated radiation therapy as part of a multimodality cancer program in a caring, patient-oriented environment.
Continued emphasis on excellence, quality and monitoring key outcome indicators is essential to achieving our goals. The prostate cancer program continues to innovate: we offer all patients who receive definitive external-beam radiation an aggressive program of high-dose intensity-modulated radiation therapy, or IMRT. Dose escalation now routinely achieves doses of 79 to 81 Gray (Gy). Image-guided radiation therapy (IGRT) and cone-beam technology are used to assure precision and accuracy in the planning and delivery of aggressive radiation doses. Monitoring of the outcomes and side effects is built into the program.
Figure 7 shows the gastrointestinal (GI) and genitourinary (GU) toxicities experienced in 252 patients who received IMRT for localized prostate cancer from January 2002 through July 2011. Acute (rapid-onset, brief) and late (long-term, prolonged) toxicities relative to IMRT administration were evaluated according to the standard Common Terminology Criteria for Adverse Events, version 4.0 (3).
Figure 7. Gastrointestinal and Genitourinary Toxicities in Patients Treated for Localized Prostate Cancer (January 2002 through July 2011, N = 252)
Toxicities (mild, moderate, severe) were evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE), version 4.0 (3).
Almost all patients (99.2% and 99.5% for acute and late toxicities, respectively) experienced no GI toxicities; the majority of patients (73% and 90% for acute and late toxicities, respectively) also had no GU toxicities. Most GU toxicities (21% and 7% for acute and late toxicities, respectively) were mild in severity and required no intervention.
Figure 8 presents a prospective quality-of-life evaluation of 75 patients that was part of a robust QA program in patients treated for prostate cancer with external-beam IMRT radiation.
Figure 8. Quality of Life Evaluation: Bowel, Hormonal and Urinary Responses in PAMF Prostate Cancer Patients After 3 to 6 Months of IMRT
(N = 225 Surveys from 75 Patients)
Data are presented before, during and after 3 to 6 months of radiation treatment, and the average patient scores are given for bowel, hormonal and urinary treatment phases. Most patients’ bowel, hormonal and urinary symptoms returned to, or approached, baseline (before-treatment) status after completing radiation treatment (Figure 8).