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dc.contributor.authorMurray, JR
dc.contributor.authorTree, AC
dc.contributor.authorAlexander, EJ
dc.contributor.authorSohaib, A
dc.contributor.authorHazell, S
dc.contributor.authorThomas, K
dc.contributor.authorGunapala, R
dc.contributor.authorParker, CC
dc.contributor.authorHuddart, RA
dc.contributor.authorGao, A
dc.contributor.authorTruelove, L
dc.contributor.authorMcNair, HA
dc.contributor.authorBlasiak-Wal, I
dc.contributor.authordeSouza, NM
dc.contributor.authorDearnaley, D
dc.date.accessioned2019-12-13T14:30:14Z
dc.date.issued2020-03-15
dc.identifier.citationInternational journal of radiation oncology, biology, physics, 2020, 106 (4), pp. 715 - 724
dc.identifier.issn0360-3016
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3473
dc.identifier.eissn1879-355X
dc.identifier.doi10.1016/j.ijrobp.2019.11.402
dc.description.abstractPURPOSE: To report a planned analysis of the efficacy and toxicity of dose escalation to the intraprostatic dominant nodule identified on multiparametric magnetic resonance imaging using standard and hypofractionated external beam radiation therapy. METHODS AND MATERIALS: DELINEATE is a single centre prospective phase 2 multicohort study including standard (cohort A: 74 Gy in 37 fractions) and moderately hypofractionated (cohort B: 60 Gy in 20 fractions) prostate image guided intensity modulated radiation therapy in patients with National Comprehensive Cancer Network intermediate- and high-risk disease. Patients received an integrated boost of 82 Gy (cohort A) and 67 Gy (cohort B) to lesions visible on multiparametric magnetic resonance imaging. Fifty-five patients were treated in cohort A, and 158 patients were treated in cohort B; the first 50 sequentially treated patients in cohort B were included in this planned analysis. The primary endpoint was late Radiation Therapy Oncology Group rectal toxicity at 1 year. Secondary endpoints included acute and late toxicity measured with clinician- and patient-reported outcomes at other time points and biochemical relapse-free survival for cohort A. Median follow-up was 74.5 months for cohort A and 52.0 months for cohort B. RESULTS: In cohorts A and B, 27% and 40% of patients, respectively, were classified as having National Comprehensive Cancer Network high-risk disease. The cumulative 1-year incidence of Radiation Therapy Oncology Group grade 2 or worse rectal and urinary toxicity was 3.6% and 0% in cohort A and 8% and 10% in cohort B, respectively. There was no reported late grade 3 rectal toxicity in either cohort. Within cohort A, 4 of 55 (7%) patients had biochemical relapse. CONCLUSIONS: Delivery of a simultaneous integrated boost to intraprostatic dominant nodules is feasible in prostate radiation therapy using standard and moderately hypofractionated regimens, with rectal and genitourinary toxicity comparable to contemporary series without an intraprostatic boost.
dc.formatPrint-Electronic
dc.format.extent715 - 724
dc.languageeng
dc.language.isoeng
dc.publisherELSEVIER SCIENCE INC
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectHumans
dc.subjectProstatic Neoplasms
dc.subjectRecurrence
dc.subjectMagnetic Resonance Imaging
dc.subjectFeasibility Studies
dc.subjectSafety
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectMale
dc.subjectRadiotherapy, Intensity-Modulated
dc.subjectRadiotherapy, Image-Guided
dc.subjectRadiation Dose Hypofractionation
dc.titleStandard and Hypofractionated Dose Escalation to Intraprostatic Tumor Nodules in Localized Prostate Cancer: Efficacy and Toxicity in the DELINEATE Trial.
dc.typeJournal Article
dcterms.dateAccepted2019-11-25
rioxxterms.versionofrecord10.1016/j.ijrobp.2019.11.402
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2020-03
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfInternational journal of radiation oncology, biology, physics
pubs.issue4
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Magnetic Resonance
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Magnetic Resonance
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume106
pubs.embargo.termsNot known
icr.researchteamClinical Academic Radiotherapy (Dearnaley)
icr.researchteamClinical Academic Radiotherapy (Huddart)
icr.researchteamMagnetic Resonance
dc.contributor.icrauthorMurray, Julia
dc.contributor.icrauthorHuddart, Robert
dc.contributor.icrauthorGao, Annie
dc.contributor.icrauthordeSouza, Nandita
dc.contributor.icrauthorDearnaley, David


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