A Single-Institution Prospective Study To Evaluate the Safety and Efficacy of Real-Time Image-Gated Spot-Scanning Proton Therapy (RGPT) for Prostate Cancer

Nishioka, Kentaro; Hashimoto, Takayuki; Mori, Takashi; Uchinami, Yusuke; Kinoshita, Rumiko; Katoh, Norio; Taguchi, Hiroshi; Yasuda, Koichi; Ito, Yoichi M.; Takao, Seishin; Tamura, Masaya; Matsuura, Taeko; Shimizu, Shinichi; Shirato, Hiroki; Aoyama, Hidefumi

A Single-Institution Prospective Study To Evaluate the Safety and Efficacy of Real-Time Image-Gated Spot-Scanning Proton Therapy (RGPT) for Prostate Cancer

Nishioka, Kentaro; Hashimoto, Takayuki; Mori, Takashi et al.

Advances in Radiation Oncology, 2024, 9(5), 101464

Permalink : https://hdl.handle.net/2115/91408

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アクセス権	open access
URI	https://hdl.handle.net/2115/91408
タイトル	A Single-Institution Prospective Study To Evaluate the Safety and Efficacy of Real-Time Image-Gated Spot-Scanning Proton Therapy (RGPT) for Prostate Cancer
著者	Nishioka, Kentaro ; Hashimoto, Takayuki ; Mori, Takashi ; Uchinami, Yusuke ; Kinoshita, Rumiko ; Katoh, Norio ; Taguchi, Hiroshi ; Yasuda, Koichi ; Ito, Yoichi M. ; Takao, Seishin ; Tamura, Masaya ; Matsuura, Taeko ; Shimizu, Shinichi ; Shirato, Hiroki ; Aoyama, Hidefumi
e-Rad_Researcher 80463743 著者名 Nishioka, Kentaro
e-Rad_Researcher 60400678 著者名 Hashimoto, Takayuki
著者名 Mori, Takashi
著者名 Uchinami, Yusuke
著者名 Kinoshita, Rumiko
著者名 Katoh, Norio
著者名 Taguchi, Hiroshi
著者名 Yasuda, Koichi
著者名 Ito, Yoichi M.
著者名 Takao, Seishin
著者名 Tamura, Masaya
e-Rad_Researcher 90590266 著者名 Matsuura, Taeko
e-Rad_Researcher 50463724 著者名 Shimizu, Shinichi
e-Rad_Researcher 20187537 著者名 Shirato, Hiroki
e-Rad_Researcher 80360915 著者名 Aoyama, Hidefumi
言語	英語
発行日	2024-05
収録物名	Advances in Radiation Oncology
巻(号)	9(5)
ページ	101464
抄録	Purpose: In real-time image-gated spot-scanning proton therapy (RGPT), the dose distribution is distorted by gold fiducial markers placed in the prostate. Distortion can be suppressed by using small markers and more than 2 fields, but additional fields may increase the dose to organs at risk. Therefore, we conducted a prospective study to evaluate the safety and short-term clinical outcome of RGPT for prostate cancer. Methods and Materials: Based on the previously reported frequency of early adverse events (AE) and the noninferiority margin of 10%, the required number of cases was calculated to be 43 using the one-sample binomial test by the Southwest Oncology Group statistical tools with the one-sided significance level of 2.5% and the power 80%. Patients with localized prostate cancer were enrolled and 3 to 4 pure gold fiducial markers of 1.5-mm diameter were inserted in the prostate. The prescribed dose was 70 Gy(relative biologic effectiveness) in 30 fractions, and treatment was performed with 3 fields from the left, right, and the back, or 4 fields from either side of slightly anterior and posterior oblique fields. The primary endpoint was the frequency of early AE (≥grade 2) and the secondary endpoint was the biochemical relapse-free survival rate and the frequency of late AE. Results: Forty-five cases were enrolled between 2015 and 2017, and all patients completed the treatment protocol. The median follow-up period was 63.0 months. The frequency of early AE (≥grade 2) was observed in 4 cases (8.9%), therefore the noninferiority was verified. The overall 5-year biochemical relapse-free survival rate was 88.9%. As late AE, grade 2 rectal bleeding was observed in 8 cases (17.8%). Conclusions: The RGPT for prostate cancer with 1.5-mm markers and 3- or 4- fields was as safe as conventional proton therapy in early AE, and its efficacy was comparable with previous studies.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
PISSN	2452-1094
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1016/j.adro.2024.101464