{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T08:48:30Z","timestamp":1745311710234},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T00:00:00Z","timestamp":1693612800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>This study investigated the outcomes of whole-pelvis radiation therapy (WPRT) using volumetric modulated arc therapy (VMAT) for high-risk prostate cancer. We retrospectively analysed 112 patients with high-risk prostate cancer who started WPRT at our hospital between August 2011 and August 2015. The prescribed dose was 78\u00a0Gy in 39 fractions to the prostate and 46.8\u00a0Gy in 26 fractions to the pelvic lymph node (LN) area. All patients received long-term androgen deprivation therapy. We evaluated late gastrointestinal (GI) and genitourinary (GU) toxicities using the Common Terminology Criteria for Adverse Events version 4.0. The median follow-up period for censored cases was 97 (interquartile range [IQR] = 85\u2013108) months. The median age was 72 (IQR = 67\u201375) years. The high-risk and very-high-risk groups included 41 (36.6%) and 71 patients (63.4%), respectively. The median risk of LN invasion calculated by the Roach formula was 36.9 (IQR = 26.6\u201356.3) %. The 8-year overall survival, biochemical failure-free survival, disease-free survival and distant metastasis-free survival rates were 88.4, 91.9, 83.8 and 98.0%, respectively. Only one patient experienced common iliac LN recurrence, which was outside the pelvic irradiation area. All patients with recurrent disease were categorized into the very-high-risk group. The 8-year cumulative rates of \u2265Grade 2 late GI and GU toxicities were 12.8 and 11.8%, respectively. No patients experienced Grade 4 or higher toxicities. WPRT using VMAT for high-risk prostate cancer was well tolerated and effective.<\/jats:p>","DOI":"10.1093\/jrr\/rrad060","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T12:29:19Z","timestamp":1693312159000},"page":"850-856","source":"Crossref","is-referenced-by-count":1,"title":["Long-term outcomes of whole-pelvis radiation therapy using volumetric modulated arc therapy for high-risk prostate cancer"],"prefix":"10.1093","volume":"64","author":[{"given":"Reiko","family":"Takemura","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Tane General Hospital , 1-12-21 Kujo-minami, Nishi-ku, Osaka-shi, Osaka 550-0025 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tane General Hospital , 1-12-21 Kujo-minami, Nishi-ku, Osaka-shi, Osaka 550-0025 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukinari","family":"Hosokawa","sequence":"additional","affiliation":[{"name":"Department of Urology, Tane General Hospital , 1-12-21 Kujo-minami, Nishi-ku, Osaka-shi, Osaka 550-0025 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideyuki","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tane General Hospital , 1-12-21 Kujo-minami, Nishi-ku, Osaka-shi, Osaka 550-0025 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shogo","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Izumi City General Hospital , 4-5-1 Wake-cho, Izumi-shi, Osaka 594-0073 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Ogino","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Osaka Metropolitan University Graduate School of Medicine , 1-4-3 Asahi-machi, Abeno-ku, Osaka-shi, Osaka 545-0051 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiko","family":"Shibuya","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Osaka Metropolitan University Graduate School of Medicine , 1-4-3 Asahi-machi, Abeno-ku, Osaka-shi, Osaka 545-0051 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,9,1]]},"reference":[{"key":"2023092300504370000_ref1","doi-asserted-by":"crossref","first-page":"e348","DOI":"10.1016\/S1470-2045(21)00242-4","article-title":"Elective nodal radiotherapy in prostate cancer","volume":"22","author":"De Meerleer","year":"2021","journal-title":"Lancet Oncol"},{"key":"2023092300504370000_ref2","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1200\/JCO.20.03282","article-title":"Prostate-only versus whole-pelvic radiation therapy in high-risk and very high-risk prostate cancer (POP-RT): outcomes from phase III randomized controlled trial","volume":"39","author":"Murthy","year":"2021","journal-title":"J Clin Oncol"},{"key":"2023092300504370000_ref3","doi-asserted-by":"crossref","first-page":"951220","DOI":"10.3389\/fonc.2022.951220","article-title":"Early results of PRO-EPI: PROspective multicenter observational study on elective pelvic nodes irradiation in patients with intermediate\/high\/very high-risk non-metastatic prostate cancer submitted to radical, adjuvant, or salvage radiotherapy with or without concomitant androgen deprivation therapy","volume":"12","author":"Guerini","year":"2022","journal-title":"Front Oncol"},{"key":"2023092300504370000_ref4","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1097\/JU.0000000000002455","article-title":"Survival outcomes in men with unfavorable intermediate-risk and high-risk prostate cancer treated with prostate-only versus whole pelvic radiation therapy","volume":"207","author":"Andruska","year":"2022","journal-title":"J Urol"},{"key":"2023092300504370000_ref5","doi-asserted-by":"crossref","first-page":"109544","DOI":"10.1016\/j.radonc.2023.109544","article-title":"ESTRO-ACROP recommendations for evidence-based use of androgen deprivation therapy in combination with external-beam radiotherapy in prostate cancer","volume":"183","author":"Schmidt-Hegemann","year":"2023","journal-title":"Radiother Oncol"},{"key":"2023092300504370000_ref6","doi-asserted-by":"crossref","first-page":"20150930","DOI":"10.1259\/bjr.20150930","article-title":"Comparison of dosimetric parameters and acute toxicity after whole-pelvic vs prostate-only volumetric-modulated arc therapy with daily image guidance for prostate cancer","volume":"89","author":"Ishii","year":"2016","journal-title":"Br J Radiol"},{"key":"2023092300504370000_ref7","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.ijrobp.2008.08.002","article-title":"RTOG GU radiation oncology specialists reach consensus on pelvic lymph node volumes for high-risk prostate cancer","volume":"74","author":"Lawton","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2023092300504370000_ref8","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.ijrobp.2016.06.2455","article-title":"Is there a role for pelvic irradiation in localized prostate adenocarcinoma? Update of the long-term survival results of the GETUG-01 randomized study","volume":"96","author":"Pommier","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2023092300504370000_ref9","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1016\/S1470-2045(18)30528-X","article-title":"Sequence of hormonal therapy and radiotherapy field size in unfavourable, localised prostate cancer (NRG\/RTOG 9413): long-term results of a randomised, phase 3 trial","volume":"19","author":"Roach","year":"2018","journal-title":"Lancet Oncol"},{"key":"2023092300504370000_ref10","first-page":"796907","article-title":"Efficacy and toxicity of whole pelvic radiotherapy versus prostate-only radiotherapy in localized prostate cancer: a systematic review and meta-analysis. Front","volume":"11","author":"Wang","year":"2022","journal-title":"Oncologia"},{"key":"2023092300504370000_ref11","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/s41391-018-0034-0","article-title":"Hypofractionated simultaneous integrated boost (IMRT-SIB) with pelvic nodal irradiation and concurrent androgen deprivation therapy for high-risk prostate cancer: results of a prospective phase II trial","volume":"21","author":"Magli","year":"2018","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"2023092300504370000_ref12","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.prro.2021.03.006","article-title":"Long-term outcomes of dose-escalated pelvic lymph node intensity-modulated radiation therapy (IMRT) with a simultaneous hypofractionated boost to the prostate for very high-risk adenocarcinoma of the prostate: a prospective phase II clinical trial","volume":"11","author":"Hall","year":"2021","journal-title":"Pract Radiat Oncol"},{"key":"2023092300504370000_ref13","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1007\/s10147-021-02002-x","article-title":"Long-term safety of high-dose whole pelvic IMRT for high-risk localized prostate cancer through 10-year follow-up","volume":"26","author":"Aizawa","year":"2021","journal-title":"Int J Clin Oncol"},{"key":"2023092300504370000_ref14","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.adro.2018.04.010","article-title":"Risk factors for late bowel and bladder toxicities in NRG oncology prostate cancer trials of high-risk patients: a meta-analysis of physician-rated toxicities","volume":"3","author":"Xiao","year":"2018","journal-title":"Adv Radiat Oncol"},{"key":"2023092300504370000_ref15","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/S1470-2045(15)00011-X","article-title":"Androgen deprivation therapy plus docetaxel and estramustine versus androgen deprivation therapy alone for high-risk localised prostate cancer (GETUG 12): a phase 3 randomised controlled trial","volume":"16","author":"Fizazi","year":"2015","journal-title":"Lancet Oncol"},{"key":"2023092300504370000_ref16","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/S0140-6736(15)01037-5","article-title":"Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial","volume":"387","author":"James","year":"2016","journal-title":"Lancet"},{"key":"2023092300504370000_ref17","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1056\/NEJMoa1702900","article-title":"Abiraterone for prostate cancer not previously treated with hormone therapy","volume":"377","author":"James","year":"2017","journal-title":"N Engl J Med"},{"key":"2023092300504370000_ref18","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1200\/JCO.18.02158","article-title":"Effect of chemotherapy with docetaxel with androgen suppression and radiotherapy for localized high-risk prostate cancer: the randomized phase III NRG oncology RTOG 0521 trial","volume":"37","author":"Rosenthal","year":"2019","journal-title":"J Clin Oncol"},{"key":"2023092300504370000_ref19","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.ijrobp.2017.02.004","article-title":"Duration of androgen deprivation in locally advanced prostate cancer: long-term update of NRG oncology RTOG 9202","volume":"98","author":"Lawton","year":"2017","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2023092300504370000_ref20","doi-asserted-by":"crossref","first-page":"2516","DOI":"10.1056\/NEJMoa0810095","article-title":"Duration of androgen suppression in the treatment of prostate cancer","volume":"360","author":"Bolla","year":"2009","journal-title":"N Engl J Med"},{"key":"2023092300504370000_ref21","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1200\/JCO.2008.17.4052","article-title":"Impact of the duration of adjuvant hormonal therapy in patients with locally advanced prostate cancer treated with radiotherapy: a secondary analysis of RTOG 85-31","volume":"27","author":"Souhami","year":"2009","journal-title":"J Clin Oncol"},{"key":"2023092300504370000_ref22","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/S1470-2045(15)70045-8","article-title":"High-dose radiotherapy with short-term or long-term androgen deprivation in localised prostate cancer (DART01\/05 GICOR): a randomised, controlled, phase 3 trial","volume":"16","author":"Zapatero","year":"2015","journal-title":"Lancet Oncol"},{"key":"2023092300504370000_ref23","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/bju.12937","article-title":"Trans-Pacific variation in outcomes for men treated with primary androgen-deprivation therapy (ADT) for prostate cancer","volume":"117","author":"Cooperberg","year":"2016","journal-title":"BJU Int"},{"key":"2023092300504370000_ref24","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/ajco.13097","article-title":"Favorable 10-year outcomes of image-guided intensity-modulated radiotherapy combined with long-term androgen deprivation for Japanese patients with nonmetastatic prostate cancer","volume":"15","author":"Tomita","year":"2019","journal-title":"Asia Pac J Clin Oncol"},{"key":"2023092300504370000_ref25","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1007\/s10147-019-01478-y","article-title":"Ten-year outcomes of high-dose intensity-modulated radiation therapy for nonmetastatic prostate cancer with unfavorable risk: early initiation of salvage therapy may replace long-term adjuvant androgen deprivation","volume":"24","author":"Aizawa","year":"2019","journal-title":"Int J Clin Oncol"}],"container-title":["Journal of Radiation Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jrr\/article-pdf\/64\/5\/850\/51724691\/rrad060.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jrr\/article-pdf\/64\/5\/850\/51724691\/rrad060.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T00:51:06Z","timestamp":1695430266000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jrr\/article\/64\/5\/850\/7258763"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,1]]},"references-count":25,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,9,1]]},"published-print":{"date-parts":[[2023,9,22]]}},"URL":"https:\/\/doi.org\/10.1093\/jrr\/rrad060","relation":{},"ISSN":["0449-3060","1349-9157"],"issn-type":[{"value":"0449-3060","type":"print"},{"value":"1349-9157","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,9]]},"published":{"date-parts":[[2023,9,1]]}}}