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Ann Geriatr Med Res > Volume 17(2); 2013 > Article
Journal of the Korean Geriatrics Society 2013;17(2):79-85.
DOI: https://doi.org/10.4235/jkgs.2013.17.2.79    Published online June 30, 2013.
Helical Tomotherapy in Elderly Prostate Cancer Patients
Yong Kan Ki, Ji Ho Nam, Won Taek Kim, Dahl Park, Dong Hyun Kim, Ju Hye Lee, Ho Sang Jeon, Dong Won Kim
1Department of Radiation Oncology, Pusan National University School of Medicine, Busan, Korea. jihonam@hanmail.net
2Department of Radiation Oncology, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
3Department of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan, Korea.
노인 전립선암 환자에서 나선형 토모테라피의 적용
기용간1,2,3·남지호1,4·김원택1,2,3박 달2,3·김동현2,3·이주혜2,3·전호상4·김동원1,2,3
부산대학교 의학전문대학원 방사선종양학교실1, 부산대학교병원 방사선종양학과2, 부산대학교병원 의생명연구원3,
양산부산대학교병원 방사선종양학과4
Abstract
BACKGROUND
Helical tomotherapy is a new form of image-guided intensity modulated radiation therapy that may improve local control and decrease radiation toxicity. The aim of this study was to evaluate if high-dose helical tomotherapy is tolerated by patients aged 75 years or older and if the side effects are comparable with those experienced by younger patients.
METHODS
Between January 2011 and August 2012, patients with prostate cancer who underwent helical tomotherapy without elective pelvic irradiation as definitive aim were reviewed and divided into two age groups: > or =75 years and <75 years. Acute genitourinary (GU) and lower gastrointestinal (GI) toxicities between the two groups were compared.
RESULTS
Twenty patients aged 75 years or older and 23 patients younger than 75 years were evaluated. Radiotherapy was administered to a total dose of 76-78Gy in 38-39 fractions or 70Gy in 28 fractions. There was no grade 3 or 4 acute toxicity and no grade 2 acute lower GI symptom, but the patients complained of grade 2 acute GU toxicity, 25.0% for the older group and 13.0% for the younger group. There was no significant difference in the rate of acute toxicity between the age groups. Hypofractionation showed a significant association with higher grade 2 acute GU toxicity (p=0.024) with the grade 2 acute GU toxicity having no significant correlation with T-stage, Gleason score, prostate specific antigen level, androgen deprivation therapy, and comorbidities.
CONCLUSION
High-dose helical tomotherapy to the prostate without pelvic irradiation was well tolerated by elderly prostate cancer patients 75 years and older.
Key Words: Helical tomotherapy, Prostate cancer, Elderly


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