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Prospective Phase II Study of Image-guided Local Boost Using a Real-time Tumor-tracking Radiotherapy (RTRT) System for Locally Advanced Bladder Cancer

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Title: Prospective Phase II Study of Image-guided Local Boost Using a Real-time Tumor-tracking Radiotherapy (RTRT) System for Locally Advanced Bladder Cancer
Authors: Nishioka, Kentaro Browse this author →KAKEN DB
Shimizu, Shinichi Browse this author →KAKEN DB
Shinohara, Nobuo Browse this author →KAKEN DB
Ito, Yoichi M. Browse this author →KAKEN DB
Abe, Takashige Browse this author →KAKEN DB
Maruyama, Satoru Browse this author →KAKEN DB
Kinoshita, Rumiko Browse this author →KAKEN DB
Harada, Keiichi Browse this author
Nishikawa, Noboru Browse this author
Miyamoto, Naoki Browse this author →KAKEN DB
Onimaru, Rikiya Browse this author →KAKEN DB
Shirato, Hiroki Browse this author →KAKEN DB
Keywords: bladder cancer
image-guided radiation therapy
combined modality therapy
Issue Date: Jan-2014
Publisher: Oxford University Press
Journal Title: Japanese Journal of Clinical Oncology
Volume: 44
Issue: 1
Start Page: 28
End Page: 35
Publisher DOI: 10.1093/jjco/hyt182
PMID: 24302759
Abstract: Objective: The real-time tumor-tracking radiotherapy system with fiducial markers has the advantage that it can be used to verify the localization of the markers during radiation delivery in real-time.We conducted a prospective Phase II study of image-guided local-boost radiotherapy for locally advanced bladder cancer using a real-time tumor-tracking radiotherapy system for positioning, and here we report the results regarding the safety and efficacy of the technique. Methods: Twenty patients with a T2-T4N0M0 urothelial carcinoma of the bladder who were clinically inoperable or refused surgery were enrolled. Transurethral tumor resection and 40 Gy irradiation to the whole bladder was followed by the transurethral endoscopic implantation of gold markers in the bladder wall around the primary tumor. A boost of 25 Gy in 10 fractions was made to the primary tumor while maintaining the displacement from the planned position at less than +2 mm during radiation delivery using a real-time tumor-tracking radiotherapy system. The toxicity, local control and survival were evaluated. Results: Among the 20 patients, 14 were treated with concurrent chemoradiotherapy. The median follow-up period was 55.5 months. Urethral and bowel late toxicity (Grade 3) were each observed in one patient. The local-control rate, overall survival and cause-specific survival with the native bladder after 5 years were 64, 61 and 65%. Conclusions: Image-guided local-boost radiotherapy using a real-time tumor-tracking radiotherapy system can be safely accomplished, and the clinical outcome is encouraging. A larger prospective multi-institutional study is warranted for more precise evaluations of the technological efficacy and patients’ quality of life.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 西岡 健太郎

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