For high risk prostate cancer, the treatment volumes and even dose levels are\nstill a controversial issue. The aim of this study is to evaluate the dosemetric\nparameters and acute toxicity of dose-escalated whole pelvis (WP) Intensity\nModulated Radiation Therapy (IMRT) and volumetric modulated arc therapy\n(VMAT) prostate boost following neoadjuvant and concomitant with androgen\ndeprivation therapy in high-risk prostate cancer patients. This analysis included\n73 high-risk prostate cancer patients treated with WP-IMRT followed by boost\nto the prostate by VMAT to total dose of 80 Gy; between January 2014 and October\n2016. Androgen deprivation therapy (ADT) was given for all patients before\nand during radiation therapy. Drawing the dose volume histograms\n(DVHs) was done for planning target volumes (PTVs), including Prostate PTV\n& nodal PTV, and organs at risk including rectum, bladder, femoral heads, and\nbowel bag for the plans. Acute radiation toxicities were reported during the\nradiation course and the following 3 months. The DVH analysis showed good\ncoverage of PTVs and organs at risk doses were acceptable. No recorded acute\nGrade greater than equal to 3 toxicity. Acute grade 1 toxicity for Gastrointestinal (GI) and Genitourinary\n(GU) were 65% and 35% respectively, while Grade 2 toxicity was 30%\nfor both. The Proctitis and frequency were the commonest acute toxicity and\nwere maximal during the 5th week of radiation therapy. Dose escalation in two\nphases utilizing Simultaneous integrated boost (SIB) combined with ADT in\nhigh risk prostate cancer patient is feasible and associated with acceptable acute\nGI and GU toxicity.
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